Abdominal X-ray in constipation in children
Author:
Mikael Häggström [notes 1]
Projectional radiography ("X-ray") of the abdomen in children for signs of constipation:
Transit time
In lower gastrointestinal series, a rather arbitrary cutoff has been suggested that children with symptoms of constipation with a colonic transit time of over 100 hours are categorized as having slow-transit constipation, and a colonic transit time of less than 100 hours as normal- or delayed-transit constipation.[1]
Colon diameters
- Main measuring sites of colon diameter.jpg
The diameters of different segments of the large intestine can be compared to the width of lumbar vertebra 2 for more consistent reference ranges on abdominal x-rays.[2]
- Ratios of large intestinal segments compared to lumbar vertebra 2.png
Ratios of large intestinal segments compared to lumbar vertebra 2, as 75th percentile, meaning that 25% of children normally have a ratio higher than this.[2]
Leech score
For children, the degree of constipation may be scored by the Leech or the Barr systems:
- The Leech system assigns a score of 0 to 5 based on the amount of feces:[3]
- 0: no visible feces
- 1: scanty feces visible
- 2: mild fecal loading
- 3: moderate fecal loading
- 4: severe fecal loading
- 5: severe fecal loading with bowel dilatation
- These score are assigned separately for the right colon, the left colon and the rectosigmoid colon, resulting in a maximum score of 15. A Leech score of 9 or greater is regarded as positive for constipation.[3]
- The Barr system rates both the amount and consistency of the faeces, and assigns a score separately for the ascending colon, transverse colon, descending colon and rectum. Its maximum score is 22, and a score of 10 or greater is regarded as positive for constipation.[4]
References
- ↑ "Colonic transit time in constipated children: does pediatric slow-transit constipation exist? ". J. Pediatr. Gastroenterol. Nutr. 23 (3): 241–51. October 1996. PMID 8890073. Archived from the original. .
- ↑ 2.0 2.1 Koppen, Ilan J. N.; Yacob, Desale; Di Lorenzo, Carlo; Saps, Miguel; Benninga, Marc A.; Cooper, Jennifer N.; Minneci, Peter C.; Deans, Katherine J.; et al. (2016). "Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years ". Pediatric Radiology 47 (3): 306–312. doi:. ISSN 0301-0449. Archived from the original. .
- ↑ 3.0 3.1 Leech, Susan C.; McHugh, Kieran; Sullivan, P. B. (1999). "Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children ". Pediatric Radiology 29 (4): 255–258. doi:. ISSN 0301-0449.
- ↑ G., Anthony; H., Kathleen (2012). The Role of Diagnostic Tests in Constipation in Children . doi:.
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