A Study on the Morphology of Ileo-Caecal Region and Its Clinical Correlations

Abstract

Background: The ileocaecal region is a juncture where the ileum enters the colon and the caecum is continuous proximally with terminal ileum and distally with the ascending colon. The ileocaecal orifice is guarded by ileocaecal valve. The caecum and the ileocaecal valve show significant variations in the shape and dimensions. The ileocaecal region is the common site for clinical conditions like polyps, diverticulae, volvulus & intussusception. Use of ileocaecal segment in bladder reconstruction surgery also makes anatomy of this region more important. The aim of our study was to elucidate the morphological variations of caecum and ileocaecal valve and their clinical importance. Materials and Methods:The present study was conducted on 100 human cadaveric specimens, during routine dissection for the undergraduate students in the department of Anatomy, K.A.P.V. Government medical college, Trichy. The size & shape of the caecum, level of its peritoneal attachment, position & shape of the ileocaecal valve, its dimensions, the distance between the ileocaecal and appendicular orifices were noted and measured.Results: The length of the caecum ranged from 2to 7 cm. The breadth of caecum ranged from 4.5 to 7cm. The shape of caecum was of Adult type in 97% of cases. The caecum was completely covered by peritoneum and not fused to the posterior abdominal wall in 75% of cases. The ileum terminates into the posteromedial aspect ofcaecum in 58% ofcases. The shape of ileocaecal orifice was slit like in 49% of cases. The height of upper labia of ileocaecal valve was within the range of 0.5cm-2.5cm, and of lower labia ranged from 0.5cm to 1cm. The diameter of ileocaecal orifice varied from 1.1 to 2.5 cm. The distance between the ileocaecal and appendicular orifices ranged between 1.7 -5cm. Conclusion:This study focused on normal and variant anatomy of caecum and ileocaecal junction. This study will be of help in radiological, ultrasonic and CT diagnosis of the ileocaecal region pathology and in planning for better therapeutic options.