Is there any role for plain abdominal radiography in the assessment of childhood constipation?
Introduction: Childhood constipation is often assessed using abdominal radiography. 2 scoring systems (Barr, Blethyn) quantify the assessment of such radiographs, but have not been validated against the gold standard of colonic transit time (CTT). This study compares scores of x-rays performed for constipation or other reasons with CTT. Methods: Measurement of CTT in 68 children generated 102 radiographs. Radiographs were scored using both systems by three screeners, (medical student, specialist registrar, consultant paediatric radiologist), blinded to CTT. Marker distribution allowed classification as colonic inertia or outflow obstruction. Scores were then re-analysed according to whether CTT was >60h (constipated). Separately 107 radiographs performed for reasons other than constipation were scored. Results: Consultant scores were significantly higher. Mean and 95% confidence interval. n = 102, p<0.
