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Measurement of Rectal Diameter and Anterior Wall Thickness by Ultrasonography in Children with Chronic Constipation
Güzide Doğan1, Merter Keçeli2, Sibel Yavuz3
1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Turkey.
Insights
Ultrasonography can measure rectal diameter and anterior wall thickness to help diagnose chronic constipation in children who cannot undergo rectal exams. This noninvasive method shows differences in constipated children, aiding diagnosis.
Area of Science:
- Pediatric gastroenterology
- Radiology
- Diagnostic imaging
Background:
- Chronic constipation is a common pediatric issue.
- Digital rectal examination is invasive and challenging in children.
- Ultrasonography offers a noninvasive alternative for rectal assessment.
Purpose of the Study:
- Determine normal rectal diameter and anterior wall thickness in children.
- Compare these measurements in constipated versus healthy children.
- Evaluate ultrasonography's feasibility for diagnosing functional constipation in uncooperative children.
Main Methods:
- 140 constipated and 164 healthy children were studied.
- Participants were categorized into four age groups.
- Rectal diameter and anterior wall thickness were measured using ultrasonography, noting fecal mass presence.
Main Results:
- Significant differences in rectal diameter were observed in constipated children (group III, fecal mass positive).
- Rectal anterior wall thickness was higher in constipated children with fecal mass compared to controls.
- Elevated anterior wall thickness was also noted in constipated children without fecal mass across multiple age groups.
Conclusions:
- Ultrasonography provides noninvasive measurements of rectal diameter and anterior wall thickness.
- These ultrasonographic parameters show potential utility in diagnosing constipation in children.
- The method is particularly useful for children who refuse digital rectal examination.
Background:
Measurement of rectal diameter by ultrasonography helps the clinician in the diagnosis of chronic constipation in children for whom rectal examination cannot be performed. The aim of the study is to determine the rectal diameter and anterior wall thickness values in constipated and healthy children and to evaluate the feasibility of ultrasonography in the diagnosis of functional constipation in children who refuse digital rectal examination.
Methods:
One hundred forty constipated and 164 healthy children participated in the study. All patients were divided into 4 subgroups according to their ages (≤3 years [group I], 3.1-6 years [group II], 6.1-12 years [group III], and >12 years [group IV]) and were referred to the radiology department. The measurement was made from above the symphysis pubis, under the ischial spine, and at the bladder neck. Anterior wall thickness measurement was performed. The measurements were recorded according to the presence or absence of fecal mass in the rectum.
Results:
Constipated children with fecal mass positive group III was found to have significant difference in all of the planes in rectal diameter measurement. Rectum anterior wall thickness measurement was found to be higher in constipated patients with fecal mass (+) compared to the control. Its measurements in constipated patients in group II, group III, and group IV with no fecal mass were found to be statistically higher than the control group.
Conclusion:
The measurement of rectal diameter and anterior wall thickness by ultrasonography as a noninvasive method was per formed in children who did not want the digital rectal examination, and it may be useful in the diagnosis of constipation.
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