WordNet

control consisting of a mechanical device for controlling the flow of a fluid
device in a brass wind instrument for varying the length of the air column to alter the pitch of a tone
one of the paired hinged shells of certain molluscs and of brachiopods
the entire one-piece shell of a snail and certain other molluscs
a structure in a hollow organ (like the heart) with a flap to insure one-way flow of fluid through it
(of brass instruments) having valves

PrepTutorEJDIC

(液体・ガスなどの流れを調節する)『バルブ』,弁 / (血液の流れを調節する)弁,弁膜 / (管楽器の)バルブ / (2枚貝の)から,貝がら / 《英》真空管

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/15 23:03:12」(JST)

wiki en

The ileocecal valve (ileocaecal valve, Tulp's valve, Bauhin's valve or colic valve) is a sphincter muscle valve that separates the small intestine and the large intestine. Its critical function is to limit the reflux of colonic contents into the ileum.^[1]

The ileocecal valve is distinctive because it is the only site in the gastrointestinal tract that is used for Vitamin B12 and bile acid absorption.^[2]^[3] Roughly two litres of fluid enters the colon daily through the ileocecal valve.

Recent evidence indicates an anatomical sphincter may also be present in humans.^[4]

Etymology

It was described by the Dutch physician Nicolaes Tulp (1593–1674), and thus it is sometimes known as Tulp's valve.

Histology

The histology of the ileocecal valve shows an abrupt change from a villous mucosa pattern of the ileum to a more colonic mucosa. A thickening of the muscularis mucosa^{[citation needed]}, which is the smooth muscle tissue found beneath the mucosal layer of the digestive tract. A thickening of the muscularis externa is also noted.^[4]

There is also a variable amount of lymphatic tissue found at the valve.^[5]

The ileocecal valve has a papillose structure.

Clinical significance

During colonoscopy, the ileocecal valve is used, along with the appendiceal orifice, in the identification of the cecum. This is important as it indicates that a complete colonoscopy has been performed. The ileocecal valve is typically located on the last fold before entry into the cecum, and can be located from the direction of curvature of the appendiceal orifice, in what is known as the bow and arrow sign.^[6]

Intubation of the ileocecal valve is typically performed in colonoscopy to evaluate the distal, or lowest part of the ileum. Small bowel endoscopy can also be performed by double-balloon enteroscopy through intubation of the ileocecal valve.^[7]

Tumors of the ileocecal valve are rare, but have been reported in the literature.^[8]^[9]

Additional images

Ileum, cecum and ascending colon
Cecum and ileum
Ileo-cecal valve
Ileo-cecal valve

References

^ Barret KE. "Lange Gastrointestinal Physiology". The McGraw-Hill Companies, 2006.
^ Fornaro, R.; Belcastro, E.; Lo Presti, G.; Carissimi, T.; Ferraris, R. (1991). "The ileocecal valve as a prognostic factor in extensive resection of the small intestine". Chirurgia italiana 43 (1–2): 49–54. PMID 1769094.
^ Steiner, M. S.; Morton, R. A. (1991). "Nutritional and gastrointestinal complications of the use of bowel segments in the lower urinary tract". The Urologic clinics of North America 18 (4): 743–754. PMID 1949406.
^ ^a ^b Pollard, MF; Thompson-Fawcett, MW; Stringer, MD (2012). "The human ileocaecal junction: anatomical evidence of a sphincter". Surgical and Radiologic Anatomy 34 (1): 21–9. doi:10.1007/s00276-011-0865-z. PMID 21863224.
^ Burkitt HG, Young B, Heath JW. Wheater's Functional Histology: a text and colour atlas. Churchill Livingstone, London, 1993.
^ Cotton PB, Williams CB. Practical Gastrointestinal Endoscopy Blackwell Publishers, London, 1996
^ Ross, AS; Waxman, I; Semrad, C; Dye, C (2005). "Balloon-assisted intubation of the ileocecal valve to facilitate retrograde double-balloon enteroscopy". Gastrointestinal endoscopy 62 (6): 987–8. doi:10.1016/j.gie.2005.09.002. PMID 16301054.
^ Yörük, G; Aksöz, K; Buyraç, Z; Unsal, B; Nazli, O; Ekinci, N (2004). "Adenocarcinoma of the ileocecal valve: report of a case". The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 15 (4): 268–9. PMID 16249985.
^ Song, HJ; Ko, BM; Cheon, YK; Ryu, CB; Lee, JS; Lee, MS; Shim, CS (2005). "Isolated ileocecal lymphoma". Gastrointestinal endoscopy 61 (2): 293–4. doi:10.1016/S0016-5107(04)02548-9. PMID 15729248.

External links

Diagram at amatsu.co.uk
largeintestine at The Anatomy Lesson by Wesley Norman (Georgetown University) (cecuminside)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 短腸症候群の病態生理 pathophysiology of the short bowel syndrome
2. 成人における短腸症候群のマネージメント management of the short bowel syndrome in adults
3. Overview of gastrointestinal tract perforation
4. 成人における大腸内視鏡検査の概要 overview of colonoscopy in adults
5. 小児における短腸症候群の慢性合併症 chronic complications of the short bowel syndrome in children

English Journal

Intestinal hemorrhage caused by Meckel's diverticulum with ectopic gastric mucosa on polypoid lesion: a case report.

Irie T1, Shinji S2, Arai H1, Kan H1, Yamada T1, Koizumi M1, Yokoyama Y1, Takahashi G1, Iwai T1, Okusa M1, Ohta K1, Uchida E1.
Surgical case reports.Surg Case Rep.2016 Dec;2(1):124. Epub 2016 Nov 4.
Meckel's diverticulum may sometimes present as an intraluminal polypoid mass causing small bowel obstruction; however, gastrointestinal bleeding due to Meckel's diverticulum with a polypoid lesion is rare. A 14-year-old girl presented with tarry stool and syncope in our hospital. Laboratory examinat
PMID 27815920

Intussusception With Cecal Cyst as Lead Point in a Child.

Lai M1, Coakley BA, Webber EM, Goldman RD.
Pediatric emergency care.Pediatr Emerg Care.2016 Nov 19. [Epub ahead of print]
Intussusception is a pediatric abdominal emergency in early childhood involving telescoping of 1 part of the bowel into another part. In most children, the condition is idiopathic with no identifiable lead point. Meckel diverticulum is the most common lead point, followed by polyps and duplication c
PMID 27870784

Absent ileocecal valve predicts the need for repeated step in children.

Wester T1, Lilja HE2, Stenström P3, Pakarinen M4.
Surgery.Surgery.2016 Nov 3. pii: S0039-6060(16)30513-X. doi: 10.1016/j.surg.2016.09.011. [Epub ahead of print]
BACKGROUND: Serial transverse enteroplasty facilitates weaning from parenteral support in selected patients with short bowel syndrome, although repeated procedure is frequently required. Our aim was to evaluate the outcome of a series of patients after serial transverse enteroplasty and define predi
PMID 27816208

Japanese Journal

急性期から治癒期までを内視鏡的に観察し得た一過性型虚血性小腸炎の1例

吹田洋將,石橋啓如,安田伊久磨,豊水道史,足立清太郎,浅木努史,片倉芳樹
日本消化器内視鏡学会雑誌 56(10), 3631-3638, 2014
症例は91歳，女性．主訴は血便，下腹部痛．初診時の大腸内視鏡検査にてBauhin弁より10cm口側の回腸に，全周性・連続性の粘膜の浮腫，白色から淡黄色の滲出物に覆われた粘膜下血腫様隆起の散在を認め，小腸造影では20cmの長さに渡りthumbprinting様の所見が確認された．第8病日の大腸内視鏡検査では同部位に厚い白苔を伴う全周性潰瘍と狭窄を認めたが，保存的加療にて症状は改善した．8カ月後の大腸 …
NAID 130004707301

Pyogenic Granuloma of the Ileum Diagnosed by Double-balloon Enteroscopy

Kikuchi Azusa,Sujino Tomohisa,Yamaoka Minoru,Yoneno Kazuaki,Ohgo Hideki,Takagi Makoto,Morioka Shingo,Hirooka Eiji,Yamamoto Keiji,Shinozuka Nozomi,Honma Taku,Kayano Hidekazu,Nakamoto Hidetomo,Imaeda Hiroyuki
Internal Medicine 53(18), 2057-2059, 2014
… We performed double-balloon enteroscopy and identified a 7-mm-diameter, reddish, subpedunculated, hemispheric polyp with a smooth surface in the small intestine, approximately 100 cm from the ileocecal valve. …
NAID 130004687657

「メッケル憩室」

Ileocecal valve
	Interior of the cecum and lower end of ascending colon with the ileocecal valve labeled as "colic valve"
	Endoscopic image of cecum with arrow pointing to ileocecal valve in foreground
Details
Latin	Valva ileocaecalis
Artery	Ileocolic artery
Vein	Ileocolic vein
Identifiers
Gray's	p.1179
MeSH	A03.556.124.684.249.400
Dorlands; /Elsevier	v_02/12843921
FMA	15973
	Anatomical terminology

　　[★]

英: Meckel diverticulum,Meckel's diverticulum
ラ: diverticulum ilei
同: Meckel憩室、先天性臍腸管憩室、臍腸管憩室
関: [[]]
同: Meckel憩室

概念

it occurs in about 2% of children, occurs within approximately 2 feet of the ileocecal valve, contains 2 types of ectopic mucosa (gastric and pancreatic), and its symptoms usually occur by age.
腸間膜対側にできる胎生期の卵黄腸管の遺残による小腸憩室。
真性憩室である。

病因

疫学

病変形成

症状

胃粘膜迷入による出血性潰瘍

診断

放射核医学

99mTcシンチグラフィ(99m過テクネチウム酸を用いたシンチグラフィ)

検査

治療

国試

097A024

「回盲弁」

　　[★]

英: :ileocecal valve (M,N), ileocecal junction (Z)
ラ: valva ileocecalis
同: バウヒン弁ボアン弁 Bauhin valve、バウヒン結腸弁 Bauhin's valve、回腸弁 valva ilealis、結腸弁 colic valve valvula coli
関: 回腸乳頭、回盲口

死後に多く認められる。口唇状の回盲口(N.274)

「ileocecal」

　　[★]

回盲部の、回盲の

関: ileocecum

「valve」

　　[★]

n.

弁

[1] Barret KE. "Lange Gastrointestinal Physiology". The McGraw-Hill Companies, 2006.

[2] Fornaro, R.; Belcastro, E.; Lo Presti, G.; Carissimi, T.; Ferraris, R. (1991). "The ileocecal valve as a prognostic factor in extensive resection of the small intestine". Chirurgia italiana 43 (1–2): 49–54. PMID 1769094.

[3] Steiner, M. S.; Morton, R. A. (1991). "Nutritional and gastrointestinal complications of the use of bowel segments in the lower urinary tract". The Urologic clinics of North America 18 (4): 743–754. PMID 1949406.

[IC-4] Pollard, MF; Thompson-Fawcett, MW; Stringer, MD (2012). "The human ileocaecal junction: anatomical evidence of a sphincter". Surgical and Radiologic Anatomy 34 (1): 21–9. doi:10.1007/s00276-011-0865-z. PMID 21863224.

[5] Burkitt HG, Young B, Heath JW. Wheater's Functional Histology: a text and colour atlas. Churchill Livingstone, London, 1993.

[6] Cotton PB, Williams CB. Practical Gastrointestinal Endoscopy Blackwell Publishers, London, 1996

[7] Ross, AS; Waxman, I; Semrad, C; Dye, C (2005). "Balloon-assisted intubation of the ileocecal valve to facilitate retrograde double-balloon enteroscopy". Gastrointestinal endoscopy 62 (6): 987–8. doi:10.1016/j.gie.2005.09.002. PMID 16301054.

[8] Yörük, G; Aksöz, K; Buyraç, Z; Unsal, B; Nazli, O; Ekinci, N (2004). "Adenocarcinoma of the ileocecal valve: report of a case". The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 15 (4): 268–9. PMID 16249985.

[9] Song, HJ; Ko, BM; Cheon, YK; Ryu, CB; Lee, JS; Lee, MS; Shim, CS (2005). "Isolated ileocecal lymphoma". Gastrointestinal endoscopy 61 (2): 293–4. doi:10.1016/S0016-5107(04)02548-9. PMID 15729248.

リンク元	「メッケル憩室」「回盲弁」
関連記事	「ileocecal」「valve」

匿名

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案内

案内

ileocecal valve