An: 2010, Nr.2, Articol Nr. 5



      T. Ţăranu, L. Frâncu, M. Moraru - Universitatea de Medicină și Farmacie „“Gr.T. Popa”” Iași, Catedra de Științe Morfologice, Disciplina de Anatomie
      Doiniţa Rădulescu - Serviciul de Anatomopatologie și Prosectură, Spitalul „“Sf. Ioan””, Iași
      MORPHOLOGY OF THE ILEOCAECAL JUNCTION(Abstract): Aim of the study was to update the functional anatomy data regarding the ileocaecal valve.Material and method: The muscular structure of the ileocaecal valve was studied through dissection under the surgical Zeiss microscope of 40 pieces (ileocaecal junction) from fresh cadavers: 20 samples immersed in 50% nitric acid solution for 48 hours and 20 pieces fixed in 10% formaldehide for 72 hours. Results: Through invagination of the terminal ileum into the postero-medial caecal wall, the two valvules of the ileo-caeco-colonic papilla (become) represent each a half of the endocaecal ileum circumference; the almost horizontal cranial valvule is attached to the colonic junction and the caudal concave valvule is attached to the caecal junction of the terminal ileum; both of them include in their structure the reduplicated borders of the intestinal mucosa (with villi on the ileal side and openings of tubular glands on the caeco-colonic side), the circular muscular layer, and the profound side of the longitudinal muscular layer. The central part of the sphincter belongs to the distal ileum while the peripheral muscular component of the sphincter is colonic in the cranial region and caecal in the caudal region. On the endopapillar contour, the circular ileal musculature is thicker and presents openings for neurovascular passage to the subjacent layers. On the outside of each valvule the circular muscular layer is becoming progressively thinner towards their free margins. Conclusions: Except for the visceral peritoneum and the superficial longitudinal layer, all the parietal structures of the terminal ileum and of the ascending colon contributes to the constitution of the ileo-caecocolonic sphincter; the ileocaecocolonic „pilor” is a complex structure that optimally provides the unidirectional passage of the distal ileal content.
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