A Handheld Ultrasound Device Can Predict Constipation with Rectal Fecal Retention in a Palliative Care Setting

Area of Science:

• Palliative Care Medicine
• Medical Imaging
• Gastroenterology

Background:

• Handheld ultrasound devices (HUDs) are increasingly common, but their diagnostic utility for fecal retention (FR) is not well-established.
• Constipation is a common issue in palliative care, often requiring accurate diagnosis of FR for effective management.

Purpose of the Study:

• To evaluate the diagnostic accuracy and usefulness of HUDs for identifying FR in constipated patients within a palliative care setting.
• To compare HUD-based FR diagnosis with computed tomography (CT) and digital rectal examination (DRE) findings.

Main Methods:

• A prospective observational study involving 134 palliative care patients with constipation.
• Rectal ultrasonographic findings from HUDs were compared against CT scans and DRE results.
• Key diagnostic metrics including sensitivity, specificity, and predictive values were calculated.

Main Results:

• HUDs demonstrated high concordance with both CT (128/134) and DRE (123/134) for FR diagnosis.
• HUDs achieved high sensitivity (93%) and specificity (97%) when compared to CT.
• HUDs showed excellent performance against DRE, with 88% sensitivity and 94% specificity.

Conclusions:

• Handheld ultrasound devices are a useful tool for diagnosing fecal retention in palliative care patients.
• HUDs offer valuable support for selecting appropriate constipation treatments.
• Further research into developing a constipation treatment algorithm based on rectal ultrasonography is recommended.