Significant Delay Posed by the Ileocecal Valve in Videocapsule Endoscopy Small Bowel Transit Time

Because the ileocecal valve could theoretically influence the progression of the videocapsule, we aimed to characterize its posed delay in videocapsule passage to the cecum. A retrospective study was conducted of all procedures in which patients experienced in the same day colonoscopy with ileal biopsy and videocapsule endoscopy. In all 11 patients who satisfied the criteria, at least one biopsy-induced ileal mucosal defect could be identified. There was a mean delay in the passage of the videocapsule through the ileocecal valve of more than 43 minutes (range: 9 seconds to 143 minutes). This article draws attention to the physiologic sphincter role of the ileocecal valve, which could significantly delay the progression of the endoscopic videocapsule to the cecum. The fact that the small bowel videocapsules may get hung up at the ileocecal valve for a while (and sometimes for a considerable amount of time) we find interesting, and essentially confirms intuition. This could be important in some circumstances, such as choosing the route for deep enteroscopy or calculation of the Lewis score.