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Difference between revisions of "Ileocecal valve"
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[[Image:Gray1075.png|thumb|200px|Drawing of the ileocecal valve (Gray's anatomy).]] | |||
The '''ileocecal valve''', abbreviated '''IC valve''', is the divider between the [[small bowel]] and cecum. It is seen by pathologist in some subtotal colectomies (e.g. right hemicoloectomies) and occasionally biopsied. | The '''ileocecal valve''', abbreviated '''IC valve''', is the divider between the [[small bowel]] and cecum. It is seen by pathologist in some subtotal colectomies (e.g. right hemicoloectomies) and occasionally biopsied. | ||
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<pre> | <pre> | ||
ILEOCECAL VALVE, BIOPSY: | ILEOCECAL VALVE, BIOPSY: | ||
- SUBMUCOSA WITH A LARGE CLUSTER OF MATURE ADIPOCYTES, SEE COMMENT. | |||
- BOWEL MUCOSA WITHIN NORMAL LIMITS. | |||
COMMENT: | COMMENT: | ||
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</pre> | </pre> | ||
==== | ====Small amount of adipose tissue==== | ||
<pre> | |||
ILEOCECAL VALVE ("PROMINENT"), BIOPSY: | |||
- COLONIC-TYPE MUCOSA WITH PROMINENT PANETH CELLS AND FOCAL LAMIMA | |||
PROPRIA NEUTROPHILS. | |||
- SMALL AMOUNT OF BENIGN (SUBMUCOSAL) ADIPOSE TISSUE. | |||
- NO DEFINITE ACUTE VALVITIS. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
====No submucosa==== | |||
<pre> | <pre> | ||
ILEOCECAL VALVE, BIOPSY: | ILEOCECAL VALVE, BIOPSY: | ||
- COLONIC-TYPE MUCOSA WITHIN NORMAL LIMITS. | |||
- NO SUBMUCOSA PRESENT. | |||
</pre> | </pre> | ||
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*Fibrin - acellular amorphous eosinophilic material. | *Fibrin - acellular amorphous eosinophilic material. | ||
*[[Neutrophil]]s. | *[[Neutrophil]]s. | ||
*Cryptitis (focal). | *[[Cryptitis]] (focal). | ||
DDx: | DDx: | ||
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*Infection, e.g. [[tuberculosis]]. | *Infection, e.g. [[tuberculosis]]. | ||
*Idiopathic - common for small lesions.<ref name=pmid18756986/> | *Idiopathic - common for small lesions.<ref name=pmid18756986/> | ||
*Mechanical forces (shear) - in a prominent IC valve. | |||
**Shearing forces are certainly present<ref name=pmid19249356>{{Cite journal | last1 = Gayer | first1 = CP. | last2 = Basson | first2 = MD. | title = The effects of mechanical forces on intestinal physiology and pathology. | journal = Cell Signal | volume = 21 | issue = 8 | pages = 1237-44 | month = Aug | year = 2009 | doi = 10.1016/j.cellsig.2009.02.011 | PMID = 19249356 }}</ref>... not studied. | |||
===Sign out=== | ===Sign out=== | ||
====Early changes due to mechanical factors in a prominent valve==== | ====Early changes due to mechanical factors in a prominent valve==== | ||
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biopsy. The cryptitis is seen focally at the tips of well-formed villi. This could be due | biopsy. The cryptitis is seen focally at the tips of well-formed villi. This could be due | ||
to mechanical factors; however, other causes should be considered clinically. | to mechanical factors; however, other causes should be considered clinically. | ||
</pre> | |||
<pre> | |||
ILEOCEAL VALVE, BIOPSY: | |||
- BOWEL MUCOSA WITH MILD ACTIVE INFLAMMATION, SEE COMMENT. | |||
-- NEGATIVE FOR GRANULOMAS. | |||
-- NEGATIVE FOR DYSPLASIA. | |||
COMMENT: | |||
The clinical history (prominent ileocecal valve) is noted. No adipose tissue is seen in | |||
this superficial mucosal biopsy. | |||
The inflammation is focal and superficial, and blunted-appearing villi are present. The | |||
changes may be due to mechanical factors; however, other causes should be considered | |||
clinically. | |||
</pre> | </pre> | ||