Assessment of Anatomical Morphology of the Ileocecal Junction and Ileocecal Valve by Dissection and Endoscopy.

Abstract

The ileocecal valve (ICV) guards the opening of the ileocecal junction (ICJ) and acts as a mechanical barrier to prevent the reflux of material from the colon into the ileum. The morphology of the ICV noted in living is different from that of cadavers. The ICV is better studied in the living by endoscopy. A study of variation in the gross anatomy of the ICV can help determine the factors responsible for its competency. A descriptive study was conducted on a total of 85 (N) patients each in two groups over a period of two years. Group I: 85 specimens of the ileocecal region obtained during dissection; Group 2: 85 patients undergoing colonoscopic study undertaken in the Department of Medical Gastroenterology. In the dissection method, the apparently normal ICJ was inspected, photographed, and measured using Vernier calipers. In the colonoscopy method, the procedure was observed and while observing ICV, photos were taken. These photographs were later compared with other photographs in the literature to identify the morphology of ICV. The age, gender, location, and morphology of ICV were represented in percentile, and qualitative variables were analyzed by Pearson correlation coefficient. Out of 85 participants in Group A, 80% (68) were males and 20% (17) were females; in Group B, 58% (49) were males, and the remaining 42% (36) were females. In the dissection method out of 85 (N) patients, 98% had reverse S type terminal ileum, correlation of diameter of ICV with age p=0.003and correlation of morphology of ICV with age p=0.006, and was statistically significant. In the colonoscopy method, 58% were males and 22% of them were 31-40 years. In 49% of patients, ICV was viewed from the left lateral position. The correlation of success of ileoscopy with age (p=0.608), gender (p=0.896), the position of the patient (p=0.236), and morphology of ICV (p=0.631)was not statistically significant. There were no age-related changes observed regarding the morphology of the ICJ. It was found that as age increases diameter of ICV increases. The success of ileoscopy was highest in 31-40 years of age.