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 A sphincter is a circular muscle that normally maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological functioning. Sphincters are found in many animals. There are over 60 types in the h ...

valve that separates the small intestine and the

large intestine The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before bein ...

. Its critical function is to limit the reflux of colonic contents into the

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 m ...

. Approximately two liters of fluid enters the colon daily through the ileocecal valve.

Microanatomy

The

histology Histology, also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vi ...

of the ileocecal valve shows an abrupt change from a

villous Villus ( la, "shaggy hair", plural villi) may refer to: * Intestinal villus, refers to any one of the small, finger-shaped outgrowths of the epithelial lining of the wall of the intestine. Clusters of projections are referred as intestinal villi. ...

mucosa pattern of the ileum to a more colonic mucosa. A thickening of the

muscularis mucosa The lamina muscularis mucosae (or muscularis mucosae) is a thin layer ( lamina) of muscle of the gastrointestinal tract, located outside the lamina propria, and separating it from the submucosa. It is present in a continuous fashion from the e ...

, which is the smooth muscle tissue found beneath the mucosal layer of the

digestive tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...

. A thickening of the

muscularis externa The muscular layer (muscular coat, muscular fibers, muscularis propria, muscularis externa) is a region of muscle in many organs in the vertebrate body, adjacent to the submucosa. It is responsible for gut movement such as peristalsis. The Latin, ...

is also noted. There is also a variable amount of

lymphatic tissue The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphatic or lymphoid o ...

found at the valve. The ileocecal valve has a

papillose This glossary of botanical terms is a list of definitions of terms and concepts relevant to botany and plants in general. Terms of plant morphology are included here as well as at the more specific Glossary of plant morphology and Glossary o ...

structure.

Clinical significance

Colonoscopy

During colonoscopy, the ileocecal valve is used, along with the appendiceal orifice, in the identification of 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, to which it is joined). The wo ...

. 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 The bow and arrow sign is an endoscopic sign for determining the location of the ileocecal valve during colonoscopy. Identifying the ileocecal valve in a colonoscopy is important, as it indicates that the entire colon has been visualized. The i ...

. Intubation of the ileocecal valve is typically performed in colonoscopy to evaluate the distal, or lowest, part of the

. Small bowel endoscopy can also be performed by

double-balloon enteroscopy Double-balloon enteroscopy, also known as push-and-pull enteroscopy, is an endoscopic technique for visualization of the small bowel. It was developed by Hironori Yamamoto in 2001. It is novel in the field of diagnostic gastroenterology as it is ...

through intubation of the ileocecal valve.

Lesions

Tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

s of the ileocecal valve are rare, but have been reported in the literature. Other benign lesions may also occur on the ileocecal valve, which are often hard to diagnose and treat surgically.

History

The ileocecal valve was described by the

Dutch Dutch commonly refers to: * Something of, from, or related to the Netherlands * Dutch people () * Dutch language () Dutch may also refer to: Places * Dutch, West Virginia, a community in the United States * Pennsylvania Dutch Country People E ...

physician

Nicolaes Tulp Nicolaes Tulp (9 October 1593 – 12 September 1674) was a Dutch surgeon and mayor of Amsterdam. Tulp was well known for his upstanding moral character and as the subject of Rembrandt's famous painting ''The Anatomy Lesson of Dr. Nicolaes Tulp' ...

(1593–1674), and thus it is sometimes known as Tulp's valve. The ileocecal valve was also described in 1588 by

Gaspard Bauhin Gaspard Bauhin or Caspar Bauhin ( la, Casparus Bauhinus; 17 January 1560 – 5 December 1624), was a Swiss botanist whose ''Pinax theatri botanici'' (1623) described thousands of plants and classified them in a manner that draws comparisons to t ...

—hence the name Bauhin's Valve or Valve of Bauhin—in the preface of his first writing,
''De corporis humani partibus externis tractatus, hactenus non editus.''

Additional images

File:Ileum, cecum and ascending colon.JPG, Ileum, cecum and ascending colon File:Cecum and ileum.JPG, Cecum and ileum File:Ileo-cecal valve.JPG, Ileo-cecal valve File:Cecum and ileum 3.JPG, Ileo-cecal valve

References

External links

Diagram at amatsu.co.uk
* () {{Digestive tract Digestive system