Are We Using Abdominal Radiographs Appropriately in the Management of Pediatric Constipation?

Area of Science:

• Pediatric Gastroenterology
• Radiology in Clinical Practice

Background:

• Pediatric constipation is a common clinical challenge.
• Abdominal radiographs (KUBs) are frequently utilized in managing pediatric constipation.

Purpose of the Study:

• To investigate the rationale behind pediatric gastroenterologists' use of abdominal radiographs in constipation management.
• To assess the impact of radiographic findings on clinical decision-making and provider confidence.

Main Methods:

• Prospective study involving 24 pediatric gastroenterologists.
• Survey of providers regarding rationale, interpretation, and management changes related to KUBs in 72 patient encounters.
• Analysis of demographic and clinical data from medical records.

Main Results:

• Stool burden evaluation (70%) and need for a clean-out (35%) were primary reasons for KUBs.
• Radiographic findings led to a change in management in 47.6% of cases.
• Provider confidence in management plans significantly increased post-radiograph (2.4 to 4.1, P < .05).

Conclusions:

• Abdominal radiographs are commonly used for diagnosis and management adjustments in pediatric constipation.
• Despite increased provider confidence, radiographic findings show poor correlation with clinical severity.
• Further education on existing constipation guidelines is needed for optimal use of imaging.