Ileocecal valve

Last revised by Dr Daniel J Bell on 01 Jan 2022

The ileocecal valve (TA: ostium ileale), also known as Bauhin valve or Tulp valve, separates the terminal ileum from the cecum and functions to regulate flow between these two structures and prevent reflux from the cecum into the small intestine

There are a large number of additional synonyms for the ileocecal valve, which include Tulpius valve (variant of Tulp valve), valve of Varolius, ileal papilla, ileocecal eminence and colic valve .

The ileocecal valve consists of two muscular layers of ileum, an upper and lower lip, that are covered by mucosa and protrude into the lumen of the caecaum supported by mucosal folds called frenula. This forms the opening of the terminal ileum into the medial cecum and delineates the upper margin of the cecum from the ascending colon.

The morphology of the ileocecal valve has be described on endoscopy as 1,3,4:

  • labial-type: slit-like opening (most common)
  • papillary-type: dome-shaped
  • lipomatous: significant amount of fat demonstrated in the lips
  • lateral (~7.5%) or posterior opening (~5%) of the terminal ileum 2,4
  • ileocecal valve is identified on barium enema as an oval or triangular-shaped filling defect with smooth or lobulated surfaces 4
  • ileocecal valve is best viewed on supine imaging
  • mixed density structure at the junction of the ileum and cecum with an average density of -25 HU (range -60 HU to +18 HU) 4

Costanzo Varolius (1543-1575) was an Italian and papal anatomist who is famously remembered for his contributions to neuroanatomy, including being the first to describe the pons; hence its historical monicker, pons Varolli 6,7.

Caspar Bauhin (1560-1624) was a Swiss anatomist, although best remembered for his botanical works. Both his father and brother, John, were also physicians 5. Bauhin glands, a synonym of the anterior lingual salivary glands were also named for him 6.

Nicolas Tulp (1593-1674), a.k.a. Nicolas Tulpius, was a Dutch physician 6.

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Cases and figures

  • Figure 1
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  • Case 1: normal ileocecal valve on fluoroscopy
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  • Case 1: relationship of ileocecal valve to appendix
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  • Case 2: fatty "lips" of the ileocecal valve
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