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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.
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.
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]
Treatment strategies should focus on identifying and correcting the root causes, where possible, resolving nutritional deficiencies, and administering antibiotics. This is especially important for patients with indigestion and malabsorption. [4] Although whether antibiotics should be a first line treatment is a matter of debate.
Patients experience abdominal pain, distension, and absolute constipation. Cecal volvulus is slightly less common than sigmoid volvulus and is associated with symptoms of abdominal pain and small bowel obstruction. Volvulus can also occur in patients with Duchenne muscular dystrophy due to smooth muscle dysfunction. [citation needed]
Gallstones can get trapped in the gastrointestinal tract, most commonly at the connection between the small and large intestines (ileocecal valve). When a gallstone gets trapped, it can lead to an intestinal obstruction, called gallstone ileus, leading to abdominal pain, vomiting, constipation, and abdominal distension. [13]
When the ileocecal valve is competent, colonic obstruction may manifest as gaseous distention of the colon, but not the small intestine; when the ileocecal valve is incompetent, it does not prevent retrograde passage of air and stool and a colonic obstruction will cause dilation of both large and small bowel.
The transverse folds of rectum (or Houston's valves or the valves of Houston) are semi-lunar transverse folds of the rectal wall that protrude into the rectum, not the anal canal as that lies below the rectum.