Advertisement

Pediatric Radiology

, 37:1247 | Cite as

The usefulness of ultrasound examination of the bowel as a method of assessment of functional chronic constipation in children

  • Artur Bijoś
  • Mieczysława Czerwionka-Szaflarska
  • Artur MazurEmail author
  • Wrzeslaw Romañczuk
Original Article

Abstract

Background

Ultrasonographic assessment of stool retention in children with chronic constipation requires the diagnosis of megarectum.

Objective

The aim of the study was to evaluate an atypical method of US assessment of megarectum, fecal impaction and enlarged colon in order to decide whether it can be used as an assessment method for children with functional chronic constipation.

Materials and methods

A total of 120 children with a positive diagnosis of chronic constipation were included in the study. All patients fulfilled the ROME II diagnostic criteria for defecation disorders. The control group comprised 105 patients with a normal defecation pattern. Children with a US diagnosis of megarectum, fecal impaction and enlarged colon were referred for proctoscopy and measurement of colonic transit time.

Results

The transverse diameter of the rectal ampulla increases with age and thus influenced the US measurements in both the patient and control groups. The numerical values of this parameter differed significantly between patients and controls in all age groups. The rectopelvic ratio is the ratio of the width of the rectal ampulla (as seen by US) to the distance between the anterior superior iliac spines (measured externally using a measuring tape). This allows the definition of megarectum. In the diagnosis of fecal impaction, US showed a sensitivity of 88.3% relative to proctoscopy. In children with fecal impaction the colonic transit time, average segmental transit time for the rectum and sigmoid colon, and average segmental transit time for the left colon were significantly longer. There was no statistically significant difference for the right side of the colon.

Conclusion

US assessment of stool retention and overfilling of the colon in children with functional chronic constipation has a high correlation with proctoscopy findings and colonic transit time. The rectopelvic ratio can be used to diagnose megarectum in children with functional chronic constipation with a cut-off value of 0.189.

Keywords

Ultrasonography Constipation Children Selection 

References

  1. 1.
    Klijn AJ, Asselman M, Vijverberg MA, et al (2004) The diameter of the rectum on ultrasonography as a diagnostic tool for constipation in children with dysfunctional voiding. J Urol 172:1986–1988PubMedCrossRefGoogle Scholar
  2. 2.
    Singh SJ, Gibbons NJ, Vincent MV, et al (2005) Use of pelvic ultrasound in the diagnosis of megarectum in children with constipation. J Pediatr Surg 40:1941–1944PubMedCrossRefGoogle Scholar
  3. 3.
    Voskuijl WP, Heijmans J, Heijmans HS, et al (2004) Use of Rome II criteria in childhood defecation disorders: applicability in clinical and research practice. J Pediatr 145:213–217PubMedCrossRefGoogle Scholar
  4. 4.
    Karaus M (1992) Functional diagnosis of the colon and anorectal area. Z Arzt Fortbild 86:91–97Google Scholar
  5. 5.
    Barr RG, Levine MD, Wilkinson RH, et al (1979) Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children. Clin Pediatr (Phila) 18:674, 676, 677–679CrossRefGoogle Scholar
  6. 6.
    Benninga MA, Buller HA, Staalman CR, et al (1995) Defaecation disorders in children, colonic transit time versus the Barr-score. Eur J Pediatr 154:277–284PubMedCrossRefGoogle Scholar
  7. 7.
    van der Plas RN, Benninga MA, Staalman CR, et al (2000) Megarectum in constipation. Arch Dis Child 83:52–58PubMedCrossRefGoogle Scholar
  8. 8.
    Meunier P, Louis D, Jaubert de Beaujeu M (1984) Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study. Gastroenterology 87:1351–1357PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Artur Bijoś
    • 1
  • Mieczysława Czerwionka-Szaflarska
    • 2
  • Artur Mazur
    • 1
    Email author
  • Wrzeslaw Romañczuk
    • 1
  1. 1.Medical FacultyUniversity of RzeszówRzeszowPoland
  2. 2.Department of Paediatrics, Allergology and GastroenterologyNicolaus Copernicus UniversityBydgoszczPoland

Personalised recommendations