Constipation in the Pediatric Emergency Department: Clinical Presentations, Diagnostic Context and Testing Patterns

Area of Science:

• Pediatric Emergency Medicine
• Gastroenterology

Background:

• Constipation in children frequently presents with non-specific symptoms, hindering its diagnosis in pediatric emergency departments (PEDs).
• Accurate identification of constipation is crucial for appropriate management and to avoid unnecessary investigations.

Purpose of the Study:

• To characterize the clinical presentations, diagnostic context, and testing patterns of children diagnosed with constipation in a tertiary pediatric emergency center.
• To identify challenges in recognizing constipation among pediatric emergency department presentations.

Main Methods:

• Retrospective analysis of medical records for patients under 18 years old discharged with ICD-10 code K59.0 (constipation) from 2021-2024.
• Data collected included demographics, presenting symptoms, and diagnostic tests performed.

Main Results:

• Constipation diagnoses represented 2.97% of all pediatric emergency visits.
• Only 26.5% of diagnosed children reported constipation as their primary complaint; common presenting symptoms included abdominal pain (61.6%) and vomiting (14.4%).
• Initial suspected diagnoses often included urinary tract infections or appendicitis, highlighting diagnostic challenges.

Conclusions:

• Constipation should be a routine consideration for children presenting with abdominal pain, vomiting, or urinary symptoms in the pediatric emergency department.
• Structured history-taking and simple diagnostic tools may improve assessment and guide further testing for pediatric constipation.