[Foreign body-induced disruption of the gastrointestinal tract-anatomy of the ileocoecal opening].
BACKGROUND
Over 75% of ingested foreign bodies pass the gastrointestinal tract without any complications. Blunt foreign bodies may lead to a disruption of the intestinal passage, mainly in the area of the ileocoecal opening. The size of the reported foreign bodies varies considerably. The aim of this study was the anatomic investigation to clarify the possible causes of obstruction and its influence on the diameter of the ileocoecal opening.


METHODS
We investigate anatomically and describe the ileocoecal opening on the basis of 27 specimens.


RESULTS
We found not a flap mechanism but a valve mechanism in the ileocoecal junction. The median diameter of the formalin-fixated specimens was 10.9 mm respectively 21.8 mm according to an assumed correction factor of 2. The cause for intestinal obstruction most probably is the ingestion of blunt, angular foreign bodies in the ostium ileale.


CONCLUSIONS
The intraindividual differences as well as the considerable size of foreign bodies that pass the ileoceocal opening support the hypothesis, that the complications described are more a consequence of an ingestion of blunt, cornered foreign bodies in the ostium ileale independent ofn the size of the ileocoecal opening itself.
Conze
J
J
Chirurgische Klinik und Poliklinik, RWTH Aachen. jconze@ukaachen.de
Krones
C J
CJ
Prescher
A
A
Ulmer
F
F
Kisielinski
K
K
Schumpelick
V
V
D002432:Cecum / Q000473:pathology / Q000601:surgery*; D005547:Foreign Bodies / Q000473:pathology / Q000601:surgery*; D005548:Foreign-Body Migration / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007077:Ileal Diseases / Q000473:pathology / Q000601:surgery*; D007080:Ileocecal Valve / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007415:Intestinal Obstruction / Q000473:pathology / Q000601:surgery*