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The aim of this paper is to present our experience in transabdominal ultrasonography of ileocecal valve lesions. The ileocecal valve, located in the central part of the ileocecal bowel segment, is rarely the primary site of disease processes. It is usually involved by pathologies in adjacent bowel segments. These are primarily infectious diseases such as yersiniosis, campylobacteriosis and salmonellosis. Typical location of Crohn’s lesions also promotes valve involvement. The appearance of the lesions in these cases is characterized by a symmetrical submucosal thickening of the bowel involved over a longer segment. Non-malignant valvular hyperplasia is relatively commonly identified as lipomatosis, manifested by symmetrical enlargement and smooth outlines. However, valvular lipoma causing an asymmetrical hyperechoic bulge is a rare finding. ileocecal valve lipomatosis or lipoma should not be misdiagnosed as a lipoma of the cecoascending part of the colon and, the other way round, a right colonic lipoma should not be mistaken for a fatty valve. Polyps on the ileocecal valve, although sometimes detected, were not identified in our material. Adenocarcinoma, which is found in the cecum in approximately ¼ of cases, is the most common malignancy, followed by neuroendocrine tumor and, rarely, lymphoma. In three cases of malignant involvement of the ileocecal valve, we observed irregular hypoechoic thickening with complete loss of wall stratification, with the lesions causing symptoms of small bowel obstruction in two of these cases. The nearly forgotten ileocecal valve syndrome, also known as Bauhin’s ileocecal valve syndrome, characterized by intermittent right iliac fossa pain, is also briefly discussed. Transabdominal ultrasound can be used as an initial diagnostic tool in some of these pathologies.

The ileocecal valve is a part of the gastrointestinal tract that separates two intestinal segments differing in both anatomy and function. Dysfunction or surgical removal of the valve usually results in the development of small intestinal bacterial overgrowth syndrome. The available literature lacks a broader discussion and ultrasound presentation of the ileocecal valve. The aim of this study is to present our experience in transabdominal ultrasound of the ileocecal valve in comparison with colonoscopic and computed tomography colonography data. In this part of the manuscript, we discuss the anatomical structures in the right iliac fossa that make up the ileocecal segment of the intestine. The ileocecal valve, which comes in two morphological forms: labial and papillary, is its central part. As shown in computed tomography colonography, the first type is more common, accounting for 76%, the second type accounts for 21%, whereas ileocecal valve lipomatosis is found in 3% of cases. Post-mortem studies have shown a significantly higher incidence of valve lipomatosis, which was found in up to 4 out of 5 cases. Our observations correspond with these findings. Ileocecal valve lipomatosis presents on ultrasound as a hyperechoic, well-circumscribed lesion, with no evident vascularity on color Doppler. This image should be differentiated especially from a lipoma, a relatively common large intestinal pathology. The paper presents two methods of preparation for an ultrasound scan (i.e. only on an empty stomach or after cleansing the intestine) and determines the optimal imaging methods for the ileocecal valve using transabdominal ultrasound. At the end of the ileocecal examination, it should be remembered to assess the lymph nodes in the right iliac fossa.