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The ileocecal valve is typically located on the last fold before entry into the cecum and can be located from the direction of curvature of the appendiceal orifice, in what is known as the bow and arrow sign. [4] Intubation of the ileocecal valve is typically performed in colonoscopy to evaluate the distal, or lowest, part of the ileum.
König's syndrome (synonym ileocaecal valve syndrome) is a syndrome of abdominal pain in relation to meals, constipation alternated with diarrhea, meteorism, gurgling sounds (hyper-peristalsis) on auscultation (especially in the right iliac fossa), and abdominal distension.
Initial management involves fluid resuscitation and potentially nasogastric suctioning. [1] Since gallstone ileus constitutes a form of mechanical small bowel obstruction, it can be a surgical emergency and requires open or laparoscopic surgery to remove an impacted stone. [1]
However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic pseudo-obstruction, Ogilvie's syndrome. [3] In 2023 the US FDA reported gastrointestinal ileus as an adverse effect of the medication semaglutide , with frequency and causal relationship unknown.
Symptoms traditionally linked to SIBO include bloating, diarrhea, constipation, and abdominal pain/discomfort. Steatorrhea may be seen in more severe cases. [4] Bacterial overgrowth can cause a variety of symptoms, many of which are also found in other conditions, making the diagnosis challenging at times. [4]
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
Depending on the location of the volvulus, symptoms may vary. For example, in patients with cecal volvulus, the predominant symptoms may be those of small bowel obstruction (nausea, vomiting and lack of stool or flatus), because the obstructing point is close to the ileocecal valve and small intestine.
When it comes to ileitis, the majority of cases are caused by an acute, self-limited form of lower right quadrant pain and/or diarrhea.However, other conditions, such as M. tuberculosis or vasculitis, can cause chronic, debilitating symptoms that are complicated by hemorrhage, obstructive symptoms, and/or extraintestinal manifestations.