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Results for “Ileocecal Valve”

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At least 19 recordsLinked to original sources
PubMed1992

Tapering of intussuscepted ileal nipple valve or ileocecal valve to correct secondary incontinence in patients with urinary reservoir.

Malfunction of the outlet mechanism, that is leakage of urine or difficulty in catheterization, has been the main problem in the evolution of continent urinary reservoirs. Urinary leakage in 3 patients with a right colonic reservoir (2 with an intussuscepted ileal nipple valve and 1 with a plicated ileal segment as a continence mechanism) was managed with tapered narrowing of the nipple valve and the ileocecal valve, respectively, using stapling techniques. Continence was thereby reestablished without impeding catheterization. Tapering is easy to perform and, when applicable, can obviate the need for a major surgical procedure.

Adult↗
PubMedDate not supplied

Genetic analysis of cancer occurring in the ileocecal valve.

The ileocecal valve consists of an upper and lower segment formed by a duplication of the wall of the small and large bowels. The origin of tumor that occurs in the ileocecal valve is often difficult to prove. The tumor in the ileocecal valve was found with endoscopic examination in a 74-year-old man. The resected specimen of the tumor was genetically studied by using PCR-SSCP (polymerase chain reaction amplification, single strand conformational polymorphism) analysis to determine the origin and direction of the tumor. PCR-SSCP analysis of p53 showed a mutation of exon 8 only in the ileum side of the tumor. This suggests that the tumor has grown towards the ileum. The cancer in the ileocecal valve is derived from the colonic part of the valve which acquired the additional genetic change of p53 mutation.

Aged↗
PubMed1986

Continent catheterizable urinary diversion using the ileocecal segment with stapled intussusception of the ileocecal valve.

A continent ileocecal reservoir was created as an alternative to ileal loop urinary diversion in 7 patients. In 3 patients the bladder neck was closed, the in situ bladder was augmented and a continent stoma was formed by intussusception of the ileocecal valve. In the remaining 4 patients an isolated cecal reservoir with a continent stoma replaced the bladder. Creation of a stoma that was continent and easy to catheterize was achieved by intussusception of the ileocecal valve with stabilization of the intussuscepted nipple using a Marlex collar. In most cases the cecal segment was hyperactive but this was controlled with anticholinergic medication. All 7 patients have a satisfactory capacity and a continent stoma without significant catheterization difficulties.

Humans↗
PubMed1984

The nipple valve as a sphincter substitute for the ileocecal valve: prevention of bacterial overgrowth in the small bowel.

We evaluated the bacteriologic effect of a nipple valve substitute for the ileocecal valve in a canine model. Resection of the ileocecal valve and the distal 40% of the jejunoileum with end-to-end anastomosis was carried out in 10 dogs. In five of the dogs chosen randomly, a nipple valve was constructed at the anastomosis; in the remainder , a two-layer jejunocolostomy was formed. Microbiologic samples were taken at operation in the ascending colon and at three sites in the small intestine before resection and at reoperation 4 weeks later. These revealed a dramatic increase in anaerobic bacteria in the distal jejunum following jejunocolostomy without valve insertion but no increase following jejunocolostomy with nipple valve. There was a seven-log difference between the two groups in the mean anaerobic bacterial counts (P less than 0.05) measured 60 cm proximal to the anastomosis at the second operation. Results of aerobic cultures were similar but less dramatic. We conclude that construction of a nipple valve jejunocolostomy prevents anaerobic bacterial colonization of the proximal small bowel and may therefore be useful in the treatment or prevention of short bowel syndrome.

Animals↗
PubMedDate not supplied

Adenomatous polyps of the ileocecal valve: report of three cases.

Lesions of the ileocecal valve are uncommon and include various inflammatory diseases, submucosal fatty infiltration, edema, and neoplasia. Of the neoplastic lesions, adenomatous polyps are distinctly rare, despite their frequency in the remainder of the colon. Three patients with adenomatous polyps of the ileocecal valve are added to the seven previously reported cases. One had a large pedunculated polyp, another had polyps resulting from familial polyposis, and the third had circumferential adenomatous polypoid hyperplasia and the ileocecal-valve syndrome. Although many lesions of the valve produce the characteristic symptoms, the diagnosis of the ileocecal-valve syndrome is seldom made. Most ileocecal-valve lesions are incidental findings on barium-enema studies and may be carefully followed. The indications for operative intervention are suspicion of malignancy and the presence of troublesome symptoms. If malignancy is likely, a right colectomy should be done. Segmental resection is the procedure of choice for the ileocecal-valve syndrome. Adenomatous polyps may require simple polypectomy, segmental resection, or even subtotal colectomy. Following recognition of these unusual disorders the exact management is individualized.

Adult↗
PubMed1997

Intubation of the ileocecal valve made easy.

Intubation of the ileocecal valve and terminal ileoscopy is useful clinically, especially in conjunction with diagnostic colonoscopy in patients with suspected or established inflammatory bowel disease or lower gastrointestinal tract bleeding. We describe a simple method of successful intubation of the ileocecal valve to facilitate ileoscopy. This method also confirms successful completion of colonoscopy, because the ileocecal valve is the most relevant endoscopic landmark of the cecum.

Endoscopy, Gastrointestinal↗
PubMedDate not supplied

[Ileocecal valve reconstruction in dogs].

PURPOSE: The importance of keeping the ileocecal valve in the intestinal ressections has been reported by several authors. When preserved, the ileocecal valve was related to a longer survival and prevention of the short bowel syndrome, due to its ability to block the colonic content reflux into the ileum and to avoid the rapid empting of the ileal content into the cecum. It was assessed a tecnique of ileocecal valve reconstitution, based on vesicoureteral anti-reflux tecniques. METHODS: Fourteen beagles were operated. Seven underwent ileocecal valve reconstitution following the tecnique proposed and in the other seven a simple end-to-end anastomosis was performed. To assess the new valve, it was done the clinical follow up, the microbiologic analysis and the manometric study. RESULTS: Clinically, during 45 days of follow up, there was no difference between the dogs with and without ileocecal reconstitution. In the aerobic bacteria analysis, the predominant bacterium was Escherichia coli. Quantitatively, the cultures grew in an irregular way, so that it was not able to compare the bacterial growth between the groups with or without ileocecal valve. The new valve had a colo-ileal reflux pressure similar to that of the physiological valve (P > 0.05). However, when compared to the non valve group, the reflux pressures of the physiological valve and new valve were significantly higher, with P < 0.05 and P < 0.001, respectively. CONCLUSION: In this study, the reconstituted ileocecal valve served as a barrier to the colo-ileal reflux just as the physiological valve does.

Animals↗
PubMed1977

[Lipomatosis of the ileocecal valve].

Lipomatosis of the ileocecal valve is a diffuse infiltration of the submucous coat with fat cells. This syndrome is discussed on the basis of a personal observation and a review of the literature. The characteristic endoscopic picture is the overgrown, yellowish lips of Bauhin's valve prolapsing into the cecum, reminiscent of a uterine cervix. Coloscopy with biopsy is therefore the method of choice in assuring proper diagnosis. On the other hand, radiology cannot recognize the disease with certainty. Generally treatment of this benign syndrome is only necessary in the event of disturbances. As a surgical procedure ileocecal resection is suggested.

Aged↗
PubMed1994

Ileocecal valve reconstruction during continent urinary diversion.

During construction of an ileocecal reservoir, such as the Mainz or Indiana pouch, the ileocecal valve is lost. Subsequently, the intestinal transit time is shortened and malabsorption as well as diarrhea may result. Patients having undergone previous bowel resection as well as children with myelomeningocele who often already have frequent defecations will be heavily affected by the loss of the ileocecal valve. We have functionally reconstructed the ileocecal valve by embedding ileum into the ascending colon via a submucosal tunnel in analogy to the technique used when creating the continence mechanism during the Mainz pouch procedure using the appendix. Experimental results in 15 dogs demonstrated that the surgically reconstructed valve genuinely mimics the physiological function of the authentic valve and confirmed a marked transit time prolongation without evidence of obstruction. Our first clinical experience in 12 patients using this operative technique is promising. Equally, the morphological appearance of the newly created valve closely resembles the genuine ileocecal valve during barium enema as well as endoscopic investigations.

Adolescent↗
PubMed2004

Adenocarcinoma of the ileocecal valve: report of a case.

Tumors of the ileocecal valve are rarely mentioned, and are mostly defined radiologically. In this manuscript, we report a case of ileocecal valve adenocarcinoma diagnosed endoscopically. The case is a male patient, 78-years-old, with abdominal pain and weight loss in whom a mass was palpated in the lower right quadrant. Abdominal ultrasound examination followed by colonoscopy and pathological diagnosis revealed adenocarcinoma of the ileocecal valve confirmed by surgical diagnosis. We report this case because of its rarity and because there is no endoscopic image in the medical literature.

Adenocarcinoma↗
PubMed2004

Ileocecal valve imaging on computed tomographic colonography.

BACKGROUND: The aim of our study was to describe the visualization, normal anatomy, and variations of the ileocecal valve with computed tomographic (CT) colonography to provide information about its optimal imaging. METHODS: We analyzed data in two- and three-dimensional rendering mode in 71 consecutive patients who underwent routine CT colonoscopy followed by conventional colonoscopy for confirmation of the radiologic findings. RESULTS: Complete visualization of the ileocecal valve was better achieved in the supine than in the prone position (82% vs. 62%, respectively); the ileocecal valve appeared in 64% of cases in the supine position when it was invisible in prone position (p < 0.0001). Partial visualization of the ileocecal valve was possible in 94% of cases. The ileocecal valve was of labial type in 76%, papillary type in 21%, and lipomatous in 3% of cases. The orifice was identified in 53% of ileocecal valves; in two cases of cecal carcinoma, the normal ileocecal valve morphology was grossly disrupted. CONCLUSION: The ileocecal valve was at least partly visualized by CT colonoscopy in 94% of cases, more frequently in the supine position. Its most common normal morphology is the labial type. The absence of orifice visualization alone is not a specific sign for neoplasia, but its presence helps distinguish physiologic bulging from neoplasia.

Adult↗
PubMed1979

[Lipomatosis of the ileocecal valve (author's transl)].

The fatty tissue of the ileocecal valve was examined in 100 autopsies. Diffuse submucosal fatty tissue was found in a different amount among children, juveniles and adults in 93% of the cases. There was no correlation between the amount of the fatty tissue and obesity or intraabdominal adhesions. As fat deposit in the ileocecal valve already can be seen in the first years of life and as it is not depleted in malnutrition it should be considered as normal and an important factor for the structure and the function of the valve. Therefore the term lipomatosis, which refers to a pathological excess of fatty tissue, no longer should be used in connection with submucosal fat in the ileocecal valve.

Adipose Tissue↗
PubMed1983

[Case of lipohyperplasia of the ileocecal valve with adenocarcinoma of the ascending colon].

A rare case of lipohyperplasia of the ileocecal valve contiguous with adenocarcinoma of the ascending colon is reported. The patient was a 67-year-old female with a chief complaint of muco-bloody stool. Barium enema X-ray study revealed a filling defect in the proximal portion of the ascending colon, suggestive of Borrmann II-type carcinoma and enlargement of the ileocecal valve. Ileocecotomy and right colectomy were performed. Histological examination disclosed that the tumor of the ascending colon consisted of well differentiated adenocarcinoma; the proliferation of fat tissue in the submucosa of the ileocecal valve was diagnosed as lipohyperplasia of the ileocecal valve. The histogenesis of this lipohyperplasia seems to be secondary development induced by the adenocarcinoma of the ascending colon.

Adenocarcinoma↗
PubMed1992

Lipohyperplasia of the ileocecal valve.

Submucosal lipohyperplasia of the ileocecal valve (ICV) is reportedly a rarely diagnosed lesion of uncertain significance. Eight cases of ICV lipohyperplasia diagnosed in surgical specimens (seven resections, one biopsy) are reviewed: three cases were associated with right lower abdominal quadrant pain and ICV mass on barium enema or operative examination, two were associated with ICV mucosal acute inflammation and necrosis, and three were incidental in resections for cecal, appendiceal, and sigmoid neoplasia. To evaluate the frequency of ICV lipohyperplasia and any associated processes, a series of 51 autopsies was studied. Regarding lipohyperplasia in these valves, 10 (19.6%) were determined to have none, 14 (27.5%) were mild, 20 (39.2%) were moderate, and 7 (13.7%) were marked cases. Degree of lipohyperplasia correlated statistically with degree of cardiac right ventricular fatty infiltration (p = 0.0001), pancreatic fatty infiltration (p = 0.0314), and greater body weight of patient (p = 0.0009). No definite correlation was demonstrated with left ventricular, adrenal, or lymph node fatty infiltration, or with hepatic fatty change, body height, age of patient, or blood glucose. Various gastrointestinal symptoms and lesions accompanied lipohyperplasia, but no definite causal relationship was identified, except for one case of marked lipohyperplasia associated with marked mucosal necrosis and acute inflammation of ICV. In conclusion, ICV lipohyperplasia is a common finding that occasionally may be associated with clinical symptoms and other valve pathology. It correlates to some extent with right ventricular and pancreatic fatty infiltration and with greater body weight.

Adult↗
PubMed2006

Atresia of the ileocecal junction with agenesis of the ileocecal valve and vermiform appendix: report of a case.

Intestinal atresia involving the ileocecal region is a very rare intestinal malformation, and the presence or absence of the ileocecal valve influences its surgical management. We report the case of a male newborn with a provisional diagnosis of distal ileal atresia, in whom laparotomy revealed that the entire ileocecal region was atretic with an absent ileocecal valve and appendix vermiformis. We resected the dilated terminal ileum together with the atretic segment and performed an ileocolic anastomosis between the terminal ileum and the transverse microcolon without valve reconstruction. When last seen, 8 months after the operation, the baby was developing normally. Ileocolic anastomosis without valve replacement appears to be sufficient if an ileocecal valve is completely absent and only a short segment of the terminal ileum is lost.

Abnormalities, Multiple↗
PubMed1999

Comparison of rejection rate and functional outcome of small bowel transplantation alone or in conjunction with the ileocecal valve versus combined small and large bowel transplantation.

Preservation of the ileocecal valve improves absorptive function and decreases the amount of small bowel needed for survival in patients with short gut syndrome. We compared the results of small and large bowel transplant (SLBTx), small bowel transplant only (SBTx), and SBTx with the ileocecal valve (ICVTx) in a porcine model. Total enterectomy was performed on 18 Yorkshire-Landrace pigs followed by orthotopic SBLTx (n = 6), SBTx (n = 6), and ICVTx (n = 6). A jejunostomy and an ileostomy were constructed for biopsies. Overall mean survival was 17 d with no statistically significant difference between groups. Rejection was seen in 6/6 SLBTx, 4/6 SBTx, and 4/6 ICVTx recipients. Acute rejection was seen in 84.3% of SLBTx, 52.3% of SBTx, and 42.5% of the ICVTx mucosal biopsy samples. Two cases of intra-abdominal infection were in the ICVTx group only. Weight loss was 147 g/d in the SLBTx group, 643 g/d in the SBTx group, and 393 g/d in the ICVTx group. While the functional outcome after SLBTx and ICVTx was noticeably better than the SBTx group, the increased rejection and intra-abdominal infection rates make transplanting the large bowel or the ileocecal valve a less attractive clinical option.

Acute Disease↗