The bow and arrow sign is an

endoscopic An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...

sign A sign is an object, quality, event, or entity whose presence or occurrence indicates the probable presence or occurrence of something else. A natural sign bears a causal relation to its object—for instance, thunder is a sign of storm, or me ...

for determining the location of the

ileocecal valve The ileocecal valve (ileal papilla, ileocaecal valve, Tulp's valve, Tulpius valve, Bauhin's valve, ileocecal eminence, valve of Varolius or colic valve) is a sphincter muscle valve that separates the small intestine and the large intestine. Its c ...

during

colonoscopy Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (''e. ...

. Identifying the ileocecal valve in a colonoscopy is important, as it indicates that the entire colon has been visualized. The identifiable landmarks in the

cecum The cecum or caecum is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body (the same side of the body as the appendix (anatomy), appendix, to which i ...

are the appendiceal orifice—which is a curvilinear indent indicating the location of the appendix from the lumen of the bowel—and the ileocecal valve, which appears as a puckering in the most distal fold of the cecum. The bow and arrow sign uses the curve of the appendiceal orifice to point toward the direction of the ileocecal valve, as if it were a bow guiding an

arrow An arrow is a fin-stabilized projectile launched by a bow. A typical arrow usually consists of a long, stiff, straight shaft with a weighty (and usually sharp and pointed) arrowhead attached to the front end, multiple fin-like stabilizers c ...

. The

colonoscope Colonoscopy () or coloscopy () is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It can provide a visual diagnosis (''e. ...

can be passed in this direction in order to enter the

terminal ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine ma ...

.Cotton PB, Williams CB. ''Practical Gastrointestinal Endoscopy'' Blackwell Publishers, London, 1996 This is used as one of two identifiable landmarks of the colon (the other being the

anus The anus (Latin, 'ring' or 'circle') is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, the residual semi-solid waste that remains after food digestion, which, d ...

), and signifies that the entire colon has been visualized.

References

{{reflist Gastroenterology