Pediatric Constipation

Etiology: usually encopresis (psychological), rarely due to anatomical cause (caudal regression syndrome, Hirschsprung disease)
AXR: check sacrum for caudal regression, characterize amount of stool as mild / moderate / severe
Clinical: common cause of recurrent abdominal pain

Radiology Cases of Constipation

AXR of constipation — AXR AP shows a marked amount of stool in the ascending colon that decreases somewhat in the transverse and descending colon but that massively distends the rectum to fill almost the entire pelvis.

AXR of constipation — AXR shows a massive amount of stool from the cecum to the rectum.

AXR of constipation — AXR shows a marked amount of stool from the cecum to the rectum.

AXR of small bowel obstruction due to constipation — AXR shows multiple extremely dilated loops of small bowel and no rectal gas.

CT of constipation causing bladder outlet obstruction — Coronal (left) and sagittal (right) images from a CT with IV and oral contrast of the abdomen shows a hugely distended bladder whose dome nearly touches the inferior margin of the liver. There is a marked amount of stool throughout the colon, especially in the rectum where a fecaloma is pinching off the bladder neck and urethra.