Kumar D, Phillips S F
Dis Colon Rectum. 1987 Jun;30(6):410-6. doi: 10.1007/BF02556486.
In 14 human autopsy specimens, obtained within two hours of death, the contribution of external ligamentous attachments to competence against reflux at the ileocecal junction (ICJ) was evaluated. The ascending colon was filled with saline by retrograde flow, and pressures at which coloileal reflux occurred were recorded. Twelve of 14 ICJ's were competent to pressures of up to 80 mm Hg; two incompetent ICJ's refluxed fluid into the ileum at intracecal pressures of approximately 40 mm Hg. Competent specimens were then restudied. Removal of mucosa at the ileocecal junction (N = 6), or a strip of circular muscle (N = 6), did not impair competence to pressures above 40 mm Hg. However, division of fibrous tissues which helped maintain an angulation between the ileum and cecum (superior and inferior ileocecal ligaments) rendered the junction incompetent in all specimens. In four samples tested, surgical reconstruction of the ileocecal angle restored competence. Comparable observations were made in three anesthetized dogs in vivo. These findings suggest that mechanical factors, maintained by the external anatomy, contribute to competence at the ICJ.
在14份于死亡后两小时内获取的人体尸检标本中，评估了外部韧带附着对回盲部（ICJ）抗反流功能的作用。通过逆行灌注将生理盐水充满升结肠，并记录发生结肠回肠反流时的压力。14个回盲部中有12个在高达80毫米汞柱的压力下具有抗反流能力；2个无抗反流能力的回盲部在盲肠内压力约为40毫米汞柱时将液体反流至回肠。然后对具有抗反流能力的标本进行再次研究。切除回盲部的黏膜（n = 6）或一条环形肌（n = 6），并不损害在40毫米汞柱以上压力时的抗反流能力。然而，切断有助于维持回肠与盲肠之间成角的纤维组织（回盲上韧带和回盲下韧带）会使所有标本中的回盲部失去抗反流能力。在4个测试样本中，回盲角的手术重建恢复了抗反流能力。在3只麻醉的犬体内进行了类似观察。这些发现表明，由外部解剖结构维持的机械因素有助于回盲部的抗反流功能。
