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Abstract：
OBJECTIVE: To evaluate bowel management for children with colorectal pathology by measuring transverse rectal diameter (TRD) and assessing fecal load with transabdominal rectal ultrasound (TRU).
METHODS: Prospective case-control study of children receiving bowel management (BM) between 04/2023 and 04/2024 was done. There was inclusion of patients with Hirschsprung disease (HD), anorectal malformation (ARM) and functional constipation (FC). Patients with other congenital or neurological conditions were excluded. Control group consisted of inpatients and outpatients without abdominal complaints. FC was diagnosed according to ROM-IV-criteria. For HD and ARM, we followed a list of symptoms. To assess fecal load, we visualized the TRD using the Klijn (Klijn et al. in J Urol 172:1986-1988, 2004) method. The bladder was moderately full. The fecal load was assessed retrograde from the rectum. Follow-up was at 1/3/6 months. Secondary data were collected from medical records. Sample size calculated a priori and follow-up group with new gathered data.
RESULTS: p value for TRD in all groups significant with p < 0.05 and in grouped follow-up.
CONCLUSIONS: Ultrasound is a useful tool for assessing fecal load and helps diagnose constipation and monitor BM. Irrespective of colorectal pathology, a cut-off of 3 cm seems to discriminate between children without constipation/overload symptoms and asymptomatic patients. We present a radiation-free method for monitoring bowel management.
METHODS: Prospective case-control study of children receiving bowel management (BM) between 04/2023 and 04/2024 was done. There was inclusion of patients with Hirschsprung disease (HD), anorectal malformation (ARM) and functional constipation (FC). Patients with other congenital or neurological conditions were excluded. Control group consisted of inpatients and outpatients without abdominal complaints. FC was diagnosed according to ROM-IV-criteria. For HD and ARM, we followed a list of symptoms. To assess fecal load, we visualized the TRD using the Klijn (Klijn et al. in J Urol 172:1986-1988, 2004) method. The bladder was moderately full. The fecal load was assessed retrograde from the rectum. Follow-up was at 1/3/6 months. Secondary data were collected from medical records. Sample size calculated a priori and follow-up group with new gathered data.
RESULTS: p value for TRD in all groups significant with p < 0.05 and in grouped follow-up.
CONCLUSIONS: Ultrasound is a useful tool for assessing fecal load and helps diagnose constipation and monitor BM. Irrespective of colorectal pathology, a cut-off of 3 cm seems to discriminate between children without constipation/overload symptoms and asymptomatic patients. We present a radiation-free method for monitoring bowel management.
摘要：
目的：通过测量直肠横径（TRD）和经腹部直肠超声（TRU）评估粪便负荷，评估结直肠病理患儿的肠道管理。
方法：对2023年4月至2024年4月接受肠道管理（BM）的儿童进行了前瞻性病例对照研究。纳入了先天性巨结肠(HD)患者，肛门直肠畸形（ARM）和功能性便秘（FC）。排除患有其他先天性或神经系统疾病的患者。对照组由无腹部不适的住院患者和门诊患者组成。根据ROM-IV标准诊断FC。对于HD和ARM，我们追踪了一系列症状.为了评估粪便负荷，我们使用Klijn可视化了TRD(Klijn等人。JUrol172：1986-1988，2004)方法。膀胱中度充满。从直肠逆行评估粪便负荷。随访时间为1/3/6个月。从医疗记录中收集次要数据。样本量通过新收集的数据计算先验和随访组。
结果：所有组的TRD的p值具有统计学意义，p<0.05和分组随访。
结论：超声是评估粪便负荷的有用工具，有助于诊断便秘和监测BM。不管结直肠病理学，3厘米的截断线似乎可以区分没有便秘/超负荷症状的儿童和无症状的患者。我们提出了一种无辐射的方法来监测肠道管理。
方法：对2023年4月至2024年4月接受肠道管理（BM）的儿童进行了前瞻性病例对照研究。纳入了先天性巨结肠(HD)患者，肛门直肠畸形（ARM）和功能性便秘（FC）。排除患有其他先天性或神经系统疾病的患者。对照组由无腹部不适的住院患者和门诊患者组成。根据ROM-IV标准诊断FC。对于HD和ARM，我们追踪了一系列症状.为了评估粪便负荷，我们使用Klijn可视化了TRD(Klijn等人。JUrol172：1986-1988，2004)方法。膀胱中度充满。从直肠逆行评估粪便负荷。随访时间为1/3/6个月。从医疗记录中收集次要数据。样本量通过新收集的数据计算先验和随访组。
结果：所有组的TRD的p值具有统计学意义，p<0.05和分组随访。
结论：超声是评估粪便负荷的有用工具，有助于诊断便秘和监测BM。不管结直肠病理学，3厘米的截断线似乎可以区分没有便秘/超负荷症状的儿童和无症状的患者。我们提出了一种无辐射的方法来监测肠道管理。
