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Fecal retention in childhood: Evaluation on ultrasonography
Reiko Hatori1, Takeshi Tomomasa2, Takashi Ishige1
1Department of Pediatrics, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Insights
Ultrasonography rectal diameter measurement is a useful diagnostic tool for identifying fecal retention in children. A measurement above the symphysis of 27 mm indicates fecal retention with high accuracy.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Colorectal Surgery
Background:
- Fecal retention is a common issue in children, often associated with functional constipation.
- Accurate diagnosis is crucial for effective management and preventing complications.
Purpose of the Study:
- To evaluate the diagnostic utility of rectal diameter measurements obtained via ultrasonography in pediatric patients.
- To determine the correlation between rectal diameter and fecal retention.
Main Methods:
- One hundred children, including those with and without constipation, were studied.
- Rectal diameter was measured using ultrasonography in three planes.
- Measurements were correlated with physical examination findings, including digital rectal examination.
Main Results:
- Children with fecal retention exhibited significantly wider rectal diameters across all measured planes compared to those without retention (P < 0.0001).
- The rectal diameter measurement above the symphysis showed the strongest correlation with fecal retention.
- A cut-off value of 27 mm for the rectal diameter above the symphysis demonstrated high sensitivity (95.5%) and specificity (94.1%) for detecting fecal retention.
Conclusions:
- Ultrasound-based rectal diameter measurement is a valuable, non-invasive tool for diagnosing fecal retention in children.
- This method offers high accuracy and can aid in clinical decision-making for pediatric constipation.
Background:
To assess the usefulness of rectal diameter measurement on ultrasonography as a diagnostic tool for fecal retention in children.
Methods:
One hundred children (median age, 5.0 years), consisting of 80 with functional constipation and 20 without constipation, participated in the study. All patients underwent physical examination that included digital rectal examination. Forty-five children underwent ultrasonography in three differential planes: transection above the symphysis; under the ischial spine; and at the bladder neck. The measurement of the rectal diameter at the transection above the symphysis could most easily detect fecal retention and had the closest correlations with retention among the three planes.
Results:
Rectal diameter was wider at all measuring points (35.2 vs 20.9 mm above the symphysis, P < 0.0001; 35.7 vs 24.0 mm under the ischial spine, P < 0.0001; and 19.4 vs 8.7 mm at the bladder neck, P < 0.0001) in children with fecal retention than in those with no fecal retention. With regard to presence of constipation, children with fecal retention had a wider rectal diameter above the symphysis than those with no fecal retention (children with functional constipation, 35.3 vs 20.0 mm, P < 0.0001; children without constipation: 32.6 vs 14.6 mm, P = 0.0026). The cut-off for the rectal diameter measured above the symphysis to identify fecal retention was 27 mm, with high sensitivity and specificity (95.5% and 94.1%, respectively).
Conclusion:
Ultrasound rectal diameter measurement can be used to detect fecal retention in children.
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