How common is colonic elongation in children with slow-transit constipation or anorectal retention?
OBJECTIVE
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). χ(2) 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).


CONCLUSIONS
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.
F Douglas Stephens Surgical Research and Gut Motility Laboratories, Murdoch Children's Research Institute, Melbourne, Australia.
Yee Ian
YI
Yik
David J
DJ
Cook
Duncan M
DM
Veysey
Coral F
CF
Tudball
Timothy M
TM
Cain
Bridget R
BR
Southwell
John M
JM
Hutson
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging / Q000473:pathology; D044684:Colon, Transverse / Q000000981:diagnostic imaging / Q000473:pathology; D003248:Constipation / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007223:Infant; D008297:Male; D009929:Organ Size; D011877:Radionuclide Imaging; D012002:Rectal Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D055815:Young Adult