The Mechanical Factor in Obstructive Cecal Perforation

Arch Surg. 1961;83(6):911-915. doi:10.1001/archsurg.1961.01300180111021.
Text Size: A A A
Published online

The inherent dangers of a closed-loop obstruction occurring in the large bowel are well known. The competency of the ileocecal valve is the single most important factor in the train of events that will occur subsequent to an obstructing colonic lesion. At the beginning of the 17th century, Bauhin described a sphincter between the cecum and the term nal ileum. He postulated that it acted mechanically to resist back-pressure. The presence of both circular and oblique muscle fibers indicates that the valve acts also as a true sphincter. In large-bowel obstruction, vomiting may occur late or not at all. With a competent ileocecal valve, a closed-loop obstruction results and the situation becomes most acute. The systemic symptoms may be misleading, and intestinal intubation will not alleviate the situation. The major danger is a mechanical perforation of the bowel, usually at the cecum; and because of this the condition requires immediate


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.