Evaluation of rectosigmoid ratio and doppler ultrasound findings in children with functional constipation: a...

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Medical Ultrasound

Background:

• Functional constipation (FC) is a common pediatric gastrointestinal disorder.
• Accurate assessment of FC and treatment response is crucial for effective patient management.
• Conventional and Doppler ultrasound (US) are non-invasive imaging modalities with potential applications in FC evaluation.

Purpose of the Study:

• To investigate the effectiveness of conventional and Doppler US in assessing the rectosigmoid ratio (R/S) and mesenteric blood flow dynamics in children with FC.
• To evaluate the utility of US in monitoring treatment response in pediatric FC.
• To explore potential correlations between R/S ratio and blood flow parameters.

Main Methods:

• A cohort of 62 children (32 with FC, 30 controls) aged 5-18 years underwent US and Doppler US.
• Measurements included rectal and sigmoid diameters, R/S ratio, and mesenteric blood flow parameters (PSV, PI, RI).
• Assessments were performed before and after a three-month treatment regimen for FC.

Main Results:

• The R/S ratio significantly improved post-treatment in the FC group (p=0.036).
• No significant changes were observed in mesenteric blood flow velocities or resistive indices with treatment.
• Lower celiac artery peak systolic velocity (PSV) was associated with an R/S ratio ≥ 1 (p=0.009).

Conclusions:

• Conventional US-based R/S ratio measurement is a useful, non-invasive tool for monitoring treatment response in pediatric functional constipation.
• Doppler US did not provide substantial clinical benefits for assessing intestinal blood flow in this FC cohort.
• Rectosigmoid measurements may aid in managing pediatric FC patients, warranting further investigation in larger studies.