Ileum

ileum, the final and longest segment of the small intestine. It is specifically responsible for the absorption of vitamin B₁₂ and the reabsorption of conjugated bile salts. The ileum is about 3.5 metres (11.5 feet) long (or about three-fifths the length of the small intestine) and extends from the jejunum (the middle section of the small intestine) to the ileocecal valve, which empties into the colon (large intestine). The ileum is suspended from the abdominal wall by the mesentery, a fold of serous (moisture-secreting) membrane.

The smooth muscle of the ileum’s walls is thinner than the walls of other parts of the intestines, and its peristaltic contractions are slower. The ileum’s lining is also less permeable than that of the upper small intestine. Small collections of lymphatic tissue (Peyer patches) are embedded in the ileal wall, and specific receptors for bile salts and vitamin B₁₂ are contained exclusively in its lining; about 95 percent of the conjugated bile salts in the intestinal contents is absorbed by the ileum.

Two percent of all humans are born with a congenital ileum malformation, called Meckel diverticulum, that consists of a side channel from 1 to 12 cm (0.4 to 4.7 inches) long extending from the intestinal wall. The malformation occurs when the duct leading from the navel to the small intestine in the fetus fails to atrophy and close. A small number of cases require surgical removal because of intestinal bleeding and inflammation.

Injury or disease affecting the terminal ileum produces vitamin B₁₂ deficiency and extensive diarrhea, the latter resulting from the interference of bile salts on water absorption in the large intestine.