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 continuousproximally with terminal ileum and distally with the ascending colon. The ileocaecal orifice is guarded byileocaecal 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 regionmore important. The aim of our study was to elucidate the morphological variations of caecum and ileocaecalvalve and their clinical importance.Materials and Methods: The present study was conducted on 100 human cadaveric specimens, during routinedissection 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 ileocaecalvalve, 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 shapeof caecum was of Adult type in 97% of cases. The caecum was completely covered by peritoneum and not fusedto the posterior abdominal wall in 75% of cases. The ileum terminates into the posteromedial aspect ofcaecumin 58% ofcases. The shape of ileocaecal orifice was slit like in 49% of cases. The height of upper labia ofileocaecal valve was within the range of 0.5cm-2.5cm, and of lower labia ranged from 0.5cm to 1cm. Thediameter of ileocaecal orifice varied from 1.1 to 2.5 cm. The distance between the ileocaecal and appendicularorifices ranged between 1.7 – 5cm.Conclusion: This study focused on normal and variant anatomy of caecum and ileocaecal junction. This studywill be of help in radiological, ultrasonic and CT diagnosis of the ileocaecal region pathology and in planning forbetter therapeutic options.