title: Colonic manometry and colonic scintigraphy as a diagnostic tool for children with severe constipation.
abstract: OBJECTIVE
  In adults, colonic manometry and colonic scintigraphy are both valuable studies in discriminating normal and abnormal colonic motility. The objective of this study was to compare the diagnostic yield and tolerability of colonic manometry and colonic scintigraphy in children with severe constipation.
  
  
  METHODS
  Twenty-six children (mean age 11.4 years, 77% boys) who had received colonic manometry and colonic scintigraphy as part of a colonic motility evaluation were included. Manometry was performed as per department protocol. After swallowing a methacrylate-coated capsule containing indium-111, images were taken at 4, 24, and 48 hours, and geometric centers were calculated. Results of both tests were categorized in 3 groups: normal, abnormal function in the distal part of the colon, and colonic inertia. Cohen κ was used for the level of agreement. Patients and parents completed a questionnaire regarding their experience.
  
  
  RESULTS
  Colonic scintigraphy showed normal transit time in 20%, delay in the distal colon in 48%, and colonic inertia in 32% of patients. Colonic manometry was normal in 40%, abnormal in the distal colon in 40%, and colonic inertia was diagnosed in 20%. The κ score was 0.34. All 5 patients with colonic inertia during manometry had a similar result by scintigraphy. Eighty-eight percent of patients preferred scintigraphy over manometry and 28% of parents preferred colonic manometry over scintigraphy.
  
  
  CONCLUSIONS
  Colonic manometry and colonic scintigraphy have a fair agreement regarding the categorization of constipation. Scintigraphy is well tolerated in pediatric patients and may be a useful tool in the evaluation of children with severe constipation.
authors.affiliation: *Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH †Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands ‡Division of Pediatric Gastroenterology and Nutrition, Goryeb Children's Hospital, Atlantic Health, Morristown, NJ §Department of Nuclear Medicine, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Mugie
authors.forename: Maria E
authors.initials: ME
authors.lastname: Perez
authors.forename: Rosa
authors.initials: R
authors.lastname: Burgers
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hingsbergen
authors.forename: Jaya
authors.initials: J
authors.lastname: Punati
authors.forename: Hayat
authors.initials: H
authors.lastname: Mousa
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.forename: Carlo Di
authors.initials: CD
authors.lastname: Lorenzo
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D003106:Colon / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003248:Constipation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D006776:Hospitals, Pediatric; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008365:Manometry / Q000009:adverse effects; D009820:Ohio; D010290:Parents; D057240:Patient Preference; D011877:Radionuclide Imaging / Q000009:adverse effects; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007205:Indium Radioisotopes