title: Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years.
abstract: BACKGROUND
  Contrast enemas with barium or water-soluble contrast agents are sometimes performed in children with severe intractable constipation to identify anatomical abnormalities. However there are no clear definitions for normal colonic size or abnormalities such as colonic dilation or sigmoid redundancy in children.
  
  
  OBJECTIVE
  To describe characteristics of colonic anatomy on air contrast enemas in children without constipation to provide normal values for colonic size ratios in children.
  
  
  METHODS
  We performed a retrospective chart review of children aged 0-5 years who had undergone air contrast enemas for intussusception. The primary outcome measures were the ratios of the diameters and lengths of predetermined colonic segments (lengths of rectosigmoid and descending colon; diameters of rectum, sigmoid, descending colon, transverse colon and ascending colon) in relation to the L2 vertebral body width.
  
  
  RESULTS
  We included 119 children (median age 2.0 years, range 0-5 years, 68% boys). Colonic segment length ratios did not change significantly with age, although the differences for the rectosigmoid/L2 ratio were borderline significant (P = 0.05). The ratios that involved the rectal and ascending colon diameters increased significantly with age, while diameter ratios involving the other colonic segments did not. Differences by gender and race were not significant.
  
  
  CONCLUSIONS
  These data can be used for reference purposes in young children undergoing contrast studies of the colon.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA. i.j.koppen@amc.nl.|Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, H7-250, PO Box 22700, 1100DD, Amsterdam, The Netherlands. i.j.koppen@amc.nl.
authors.forename: Ilan J N
authors.initials: IJ
authors.lastname: Koppen
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Desale
authors.initials: D
authors.lastname: Yacob
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Saps
authors.affiliation: Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, H7-250, PO Box 22700, 1100DD, Amsterdam, The Netherlands.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.affiliation: Center for Surgical Outcomes Research, Research Institute Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Cooper
authors.affiliation: Center for Surgical Outcomes Research, Research Institute Nationwide Children's Hospital, Columbus, OH, USA.|Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Minneci
authors.affiliation: Center for Surgical Outcomes Research, Research Institute Nationwide Children's Hospital, Columbus, OH, USA.|Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Deans
authors.affiliation: Department of Radiology, Nationwide Children' Hospital, Columbus, OH, USA.
authors.forename: D Gregory
authors.initials: DG
authors.lastname: Bates
authors.affiliation: Department of Radiology, Nationwide Children' Hospital, Columbus, OH, USA.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Thompson
mesh_terms: D001466:Barium Sulfate; D002675:Child, Preschool; D003106:Colon / Q000033:anatomy & histology*; D003287:Contrast Media; D004733:Enema; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007327:Insufflation; D007443:Intussusception / Q000000981:diagnostic imaging; D008297:Male; D012016:Reference Values; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: Children; Colon; Contrast enema; Dilatation; Normal values; Rectum