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A study of an anatomic–physiological cecocolonic sphincter in humans

机译：人体解剖生理学中的结肠结肠括约肌的研究

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We hypothesized an anatomical/physiological sphincter and investigated this hypothesis in current communication. The histomorphologic and morphometric studies were carried out in 14 cadavers and radiologic studies in 20; endoscopy studies were done in 16 healthy volunteers. Longitudinal sections along cecum, cecocolonic junction, and ascending colon were stained with H & E and Masson's trichrome stain. Morphometry study of musclethickness of cecum, cecocolonic junction, and ascending colon, radiological examination by method of small bowel barium meal administration, and endoscopic study by pancolonoscopy were studied. A cecocolonic fold was identified 2–2.5 cm distal to ileocecal nipple. It extended along gut circumference, shelf-like, and was marked by a shallow groove on outer aspect of colon. Microscopically, cecocolonic fold consisted of mucosa, submucosa, and muscularis externa. The circular muscle layer was thicker than that of cecum or ascending colon. Branching cells with ovoid nuclei representing probably intestinal cells of Cajal were identified in muscularis externa. Also morphometric study showed that circular muscle layer was significantly thicker than that of cecum or ascending colon, whereas longitudinal muscle exhibited no significant difference. Radiologic studies demonstrated narrowing at cecocolonic junction, which became wider on cecal contraction and narrower or closed on colonic contraction. Endoscopically, cecocolonic junction was narrow due to presence of cecocolonic fold, which exhibited spontaneous contractions. Our findings suggest an “anatomic” sphincter at cecocolonic junction as evidenced histomorphometrically, radiologically and endoscopically. Detection of interstitial cells of Cajal in cecocolonic fold postulates possible existence a pacemaker in cecocolonic fold, a point that needs further study. Clin. Anat. 23:851–861, 2010. ? 2010 Wiley-Liss, Inc.
机译：我们假设一个解剖/生理括约肌，并在当前的交流中研究了这个假设。在14具尸体中进行了组织形态学和形态计量学研究，在20具中进行了放射学研究。内镜检查在16名健康志愿者中进行。沿盲肠，盲肠结肠交界处和升结肠的纵向切片用H＆E和Masson三色染色剂染色。研究了盲肠，盲肠结肠交界处和升结肠的肌肉厚度的形态计量学研究，小肠钡餐给药方法的放射学检查以及腹腔镜检查的内窥镜检查。回盲肠乳头远端2–2.5 cm处发现盲肠褶皱。它沿肠周围延伸，呈架子状，并在结肠外表面有一浅槽。显微镜下，结肠结肠褶皱由粘膜，粘膜下层和外肌层组成。环状肌层比盲肠或升结肠大。在外层肌肉中鉴定出带有卵形核的分支细胞，可能代表了Cajal的肠道细胞。形态计量学研究还表明，环形肌肉层比盲肠或升结肠明显厚，而纵向肌肉则无明显差异。放射学研究表明，在结肠结肠交界处变窄，在盲肠收缩时变宽，在结肠收缩时变窄或闭合。内窥镜下，由于结肠结肠褶皱的存在，结肠结肠交界处狭窄，表现出自发性收缩。我们的发现表明，在结肠结肠交界处有一个“解剖”括约肌，从组织形态学，放射学和内窥镜检查都可以看出。在结肠结肠褶皱中检测到Cajal的间质细胞，推测在结肠结肠褶皱中可能存在起搏器，这一点需要进一步研究。临床阿纳特23：851–861，2010。 2010 Wiley-Liss，Inc.

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