Ileocecal valve

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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.

Lipomatous ileocecal valve

  • AKA lipomatosis of the ileocecal valve

General

  • The lesion should involve the valve circumferentially.
    • True lipomas of the ileocecal have a capsule, are not circumferential and less common.[1]

Clinical:

Gross

  • "Ileocecal valve prominent".

Microscopic

Feature:

  • Mature adipocytes.
  • No capsule.[1]

DDx:

  • Lipoma of the ileocecal valve - have a capsule.

Image:

Sign out

ILEOCECAL VALVE, BIOPSY:
   - SUBMUCOSA WITH A LARGE CLUSTER OF MATURE ADIPOCYTES, SEE COMMENT.
   - BOWEL MUCOSA WITHIN NORMAL LIMITS.

COMMENT:
The findings are consistent with a lipomatous ileocecal valve.

Ileocecal tuberculosis

General

  • Ileocecal region and jejunoileal region are the most commonly affected areas in gastrointestinal tuberculosis.[5][6][7]

Microscopic

See Tuberculosis.

Ileocecal valve ulceration

General

  • Relatively uncommon.

Microscopic

Features:

  • Fibrin - acellular amorphous eosinophilic material.
  • Neutrophils.
  • Cryptitis (focal).

DDx:

See also

References

  1. 1.0 1.1 Skaane, P.; Eide, TJ.; Westgaard, T.; Gauperaa, T. (Dec 1981). "Lipomatosis and true lipomas of the ileocecal valve.". Rofo 135 (6): 663-8. doi:10.1055/s-2008-1056492. PMID 6212382.
  2. Petrović, J.; Barisić, G.; Saranović, D.; Micev, M.; Krivokapić, Z. (Sep 2007). "Lipomatosis of the ileocecal valve treated with right hemicolectomy as the consequence of an incomplete diagnostic procedure.". Tech Coloproctol 11 (3): 278-80. doi:10.1007/s10151-007-0366-6. PMID 17676259.
  3. Bhupalan, AJ.; Forbes, A.; Lloyd-Davies, E.; Wignall, B.; Murray-Lyon, IM. (Jun 1992). "Lipomatosis of the ileocaecal valve simulating Crohn's disease.". Postgrad Med J 68 (800): 455-6. PMID 1437927.
  4. Dultz, LA.; Ullery, BW.; Sun, HH.; Huston, TL.; Eachempati, SR.; Barie, PS.; Shou, J.. "Ileocecal valve lipoma with refractory hemorrhage.". JSLS 13 (1): 80-3. PMC 3015905. PMID 19366548. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015905/.
  5. Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 282. ISBN 978-0443066573.
  6. Bhargava, DK.; Tandon, HD.; Chawla, TC.; Shriniwas, BN.; Tandon, BM.; Kapur, . (Apr 1985). "Diagnosis of ileocecal and colonic tuberculosis by colonoscopy.". Gastrointest Endosc 31 (2): 68-70. PMID 3922847.
  7. Engin, G.; Balk, E.. "Imaging findings of intestinal tuberculosis.". J Comput Assist Tomogr 29 (1): 37-41. PMID 15665681.
  8. 8.0 8.1 Liu, JX.; Wang, HH. (Mar 2008). "[Clinical and pathological features of benign ileocecal ulcerative lesions discovered by ileocolonoscopy: analysis of 31 cases].". Zhonghua Yi Xue Za Zhi 88 (12): 823-5. PMID 18756986.