Small Bowel Transit Scintigraphy in Children With Pediatric Intestinal Pseudo-Obstruction.

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Gastrointestinal Motility Disorders

Background:

• Pediatric Intestinal Pseudo-obstruction (PIPO) diagnosis relies on objective evidence of small intestinal dysmotility.
• Small Bowel Scintigraphy (SBS) measures small bowel transit (SBT) but has limited pediatric data.
• Evaluating SBS utility in children with suspected gastrointestinal dysmotility is crucial.

Purpose of the Study:

• To assess the diagnostic utility of Small Bowel Scintigraphy (SBS) in children suspected of gastrointestinal dysmotility.
• To evaluate SBS for diagnosing and characterizing Pediatric Intestinal Pseudo-obstruction (PIPO).
• To compare SBT in PIPO patients versus non-PIPO patients and correlate with antroduodenal manometry (ADM).

Main Methods:

• Retrospective analysis of 59 pediatric patients (2016-2022) undergoing extended gastric emptying studies for SBT assessment.
• PIPO classification based on antroduodenal manometry (ADM) findings.
• Comparison of SBS parameters, including colonic filling at 6 hours, between PIPO and non-PIPO groups.

Main Results:

• PIPO patients showed significantly lower colonic filling at 6 hours compared to non-PIPO patients (liquid: 48% vs 83%; solid: 5% vs 65%).
• Small bowel transit (SBT) was significantly slower in myopathic PIPO compared to neuropathic PIPO for both liquid and solid meals.
• A significant negative correlation was observed between solid SBT and ADM scores (r = -0.638, P = 0.036).

Conclusions:

• Small Bowel Scintigraphy (SBS) is a feasible method for assessing pediatric small intestinal motility.
• SBS demonstrates potential utility in diagnosing and characterizing Pediatric Intestinal Pseudo-obstruction (PIPO).
• SBS appears most effective in differentiating myopathic PIPO; further studies in larger pediatric cohorts are warranted.