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.
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.