How common is colonic elongation in children with slow-transit constipation or anorectal retention?

Abstract Purpose Colonic elongation is reported as a possible cause for slow colonic transit, as it is observed in patients with slow-transit constipation (STC). This study aimed to determine the frequency of colonic elongation in children with STC or anorectal retention using radioimaging. We hypot...

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Bibliographic Details
Published in:Journal of pediatric surgery 2012-07, Vol.47 (7), p.1414-1420
Main Authors: Yik, Yee Ian, Cook, David J, Veysey, Duncan M, Tudball, Coral F, Cain, Timothy M, Southwell, Bridget R, Hutson, John M
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Chronic constipation
Chronic Disease
Colon - diagnostic imaging
Colon - pathology
Colon, Sigmoid - diagnostic imaging
Colon, Sigmoid - pathology
Colon, Transverse - diagnostic imaging
Colon, Transverse - pathology
Colonic elongation
Constipation - diagnostic imaging
Constipation - pathology
Constipation - physiopathology
Female
Gastrointestinal Transit
Humans
Infant
Male
Nuclear transit scintigraphy (NTS)
Organ Size
Pediatrics
Radionuclide Imaging
Rapid transit
Rectal Diseases - diagnostic imaging
Rectal Diseases - pathology
Rectal Diseases - physiopathology
Retrospective Studies
Slow-transit constipation (STC), Anorectal retention
Surgery
Young Adult
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Summary:Abstract Purpose Colonic elongation is reported as a possible cause for slow colonic transit, as it is observed in patients with slow-transit constipation (STC). This study aimed to determine the frequency of colonic elongation in children with STC or anorectal retention using radioimaging. We hypothesized that transverse colon elongation may occur in patients with STC, whereas sigmoid colon elongates in patients with anorectal retention. Methods Nuclear transit scintigraphy performed for chronic constipation (1999-2011) was analyzed qualitatively for elongated transverse colon or sigmoid colon. Three major colonic transit patterns were identified: slow transit in the proximal colon (STC), normal proximal colonic transit with anorectal retention (NT-AR), and rapid proximal transit ± anorectal retention (RT). χ2 Test was used for statistical analysis ( P < .05 significant). Results From 1999 to 2011, 626 children had nuclear transit scintigraphy. Transverse colon elongation occurred more frequently in STC (73/322, or 23%) compared with NT-AR (9/127, or 7%) and RT (5/177, or 3%; P < .0001). Sigmoid colon elongation was equally common in NT-AR (8/127, or 6%) compared with RT (10/177, or 6%) and STC (14/322, or 4%; P < .9). Conclusion Transverse colon elongation is more common in STC (23%), whereas sigmoid colon elongation is not more common in anorectal retention. Colonic elongation may be the cause or the result of the underlying slow colonic transit.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2012.01.007