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Is rectal disimpact always necessary in children with chronic constipation? Evaluation with pelvic ultrasound

Maria Rita Di Pace1, Pieralba Catalano, Anna Maria Caruso

  • 1Pediatric Surgical Unit, Department of Mother and Child Care, University of Palermo, Palermo, Italy.

Pediatric Surgery International
|April 24, 2010
PubMed

Insights

Pelvic ultrasound helps manage pediatric chronic idiopathic constipation by identifying rectal distension. This allows for tailored treatment, improving outcomes for children with constipation.

Area of Science:

  • Pediatric Gastroenterology
  • Medical Imaging
  • Clinical Diagnostics

Background:

  • Chronic idiopathic constipation is common in children.
  • Accurate diagnosis and management are crucial for effective treatment.

Purpose of the Study:

  • To assess the utility of pelvic ultrasound in managing pediatric chronic idiopathic constipation.
  • To determine if pelvic ultrasound can guide treatment strategies.

Main Methods:

  • 270 children with chronic idiopathic constipation were evaluated using clinical scores and pelvic ultrasound.
  • Patients were grouped based on rectal diameter measurements (>3 cm or <3 cm/not visualized).
  • Treatment protocols were assigned based on ultrasound findings and randomized subgroups.

Main Results:

  • Group A1 (rectal diameter >3 cm, with disimpaction) showed rapid improvement and reduced rectal size.
  • Group A2 (rectal diameter >3 cm, without disimpaction) had poor response and no significant change in rectal diameter.
  • Groups B1 and B2 (rectal diameter <3 cm or not visualized) showed improvement after 2-3 months.

Conclusions:

  • Pelvic ultrasound is valuable for diagnosing significant rectal distension (MR).
  • Disimpaction is indicated only when significant rectal distension is present.
  • Pelvic ultrasound aids in establishing appropriate, individualized treatment protocols for pediatric constipation.
Abstract

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