Diagnostic Value of Abdominal Radiography, Abdominal Ultrasound and Transit Studies Time in Children with Chronic Idiopathic Constipation

Bibliographic InformationReason for rejecting study
Centre for Reviews and Dissemination. Diagnostic value of abdominal radiography in constipated children: a systematic review (Structured abstract). 2008. Database of Abstracts of Reviews of Effects [2]Structured abstract of a systematic review already included this review
Eidlitz-Markus et al. Occult constipation: A common cause of recurrent abdominal pain in childhood. 2004. Israel Medical Association Journal 6[11], 677-680Israel.No pre-diagnosis was reported. Not clear why some patients underwent X-rays in the first place if their clinical diagnosis of constipation was “overt constipation” according to the authors' definition. Not clear why some children who already had a diagnosis of “occult constipation by DRE according to the authors definition, undergo X-rays subsequently. Lack of control group
Afzal et al. Constipation with acquired megarectum in children with autism. 2003. Pediatrics 112[4], 939-942Poor methodological paper. No data on diagnostic value were reported: symptoms of constipation not clearly related to the outcomes of a plain abdominal radiography. Faecal impaction no clinically defined.
El-Salhy. Chronic idiopathic slow transit constipation: pathophysiology and management. 2003. Colorectal Disease 5[4], 288-296Review paper. No specific diagnostic data on transit time, but on pathophysiology of chronic idiopathic slow transit constipation.
Hutson et al. Chronic constipation: No longer stuck! Characterization of colonic dysmotility as a new disorder in children. 2004. Journal of Pediatric Surgery 39[6], 795-799United States.Review paper. Some diagnostic data on CTT from study already included
Bouchoucha et al. Colonic response to food in constipation. 2006. International Journal of Colorectal Disease 21[8], 826-833Population age not reported. No explicit references to children
Zarate et al. In patients with slow transit constipation, the pattern of colonic transit delay does not differentiate between those with and without impaired rectal evacuation. 2008. American Journal of Gastroenterology 103[2], 427-434Age range 18-73 years. (mean 41 years)
van der Plas et al. Megarectum in constipation. 2000. Archives of Disease in Childhood 83[1], 52-58The study did not use plain abdominal radiography, but abdominal radiography after a barium enema in order to measure the recto-pelvic ratio (RPR)
Guo et al. Categorization of dysmotility in patients with chronic constipation and its significance for management. 2004. Chinese Journal of Digestive Diseases 5[3], 98-102Age range 16-82 years (mean 44 years)
McLean et al. The utilization of colon transit scintigraphy in the diagnostic algorithm for patients with chronic constipation. 1999. Digestive Diseases and Sciences 44[1], 41-47Age >18 years
O'Brien et al. Motility and tone of the left colon in constipation: a role in clinical practice? 1996. American Journal of Gastroenterology 91[12], 2532-2538Age range 16-74 years (mean >33)
Pemberton et al. Evaluation and surgical treatment of severe chronic constipation. 1991. Annals of Surgery 214[4], 403-411Mean age > 33 years
Fink et al. The role of manometry, electromyography and radiology in the assessment of intractable constipation. 1992. Australian and New Zealand Journal of Surgery 62[12], 959-964Age range 15-75 (mean 41.3 years)
Eising et al. Differentiation of prolonged colonic transit using scintigraphy with indium-111-labeled polystyrene pellets. 1998. Journal of Nuclear Medicine 39[6], 1062-1066Age range 8-68 years (mean 41.7 years)
Marcovitch. Colonic transit times and behaviour profiles in children with defecation disorders. 2004. Archives of Disease in Childhood 89[1], 2United Kingdom.Commentary paper
Christensen et al. Scintigraphic assessment of retrograde colonic washout in fecal incontinence and constipation. 2003. Diseases of the Colon and Rectum 46[1], 68-76Age range 10-80 years (median 46 years)
Wexner et al. Colorectal physiological tests: use or abuse of technology? 1994. European Journal of Surgery 160[3], 167-174Age range 12-85 years (mean 64 years in women and 60 in men)
Bouchoucha et al. Error analysis of classic colonic transit time estimates. 2000. American Journal of Physiology - Gastrointestinal and Liver Physiology 279[3], G520-G527Age range 17-80 years (mean 45.3 years) (all control subjects >18 years)
Glia et al. Clinical value of symptom assessment in patients with constipation. 1999. Diseases of the Colon and Rectum 42[11], 1401-1410United States.Age range 17-79 years (median 52 years)
Halverson et al. Which physiologic tests are useful in patients with constipation? 1998. Diseases of the Colon and Rectum 41[6], 735-739Age range 16-78 years (mean 48 years)
Ducrotte et al. Colonic transit time of radiopaque markers and rectoanal manometry in patients complaining of constipation. 1986. Diseases of the Colon and Rectum 29[10], 630-634Population > 18 years
Bassotti et al. Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation. 1994. Digestive Diseases and Sciences 39[7], 1558-1564Population > 18 years
Chaussade et al. Determination of total and segmental colonic transit time in constipated patients. Results in 91 patients with a new simplified method. 1989. Digestive Diseases and Sciences 34[8], 1168-1172Population > 18 years
Glia et al. Quality of life in patients with different types of functional constipation. 1997. Scandinavian Journal of Gastroenterology 32[11], 1083-1089Age range 17-79 years (median 53 years)
Charles et al. Scintigraphy of the whole gut: clinical evaluation of transit disorders. 1995. Mayo Clinic Proceedings 70[2], 113-118Population > 18 years
Nurko. What's the value of diagnostic tools in defecation disorders? 2005. Journal of Pediatric Gastroenterology and Nutrition 41[SUPPL. 1], S53-S55United States.Review paper
Clarke et al. Quality of life in children with slow transit constipation. 2008. Journal of Pediatric Surgery 43[2], 320-324Not related to diagnostic value of colonic transit time. might be included in further review on quality of life
Wald et al. Psychological and physiological characteristics of patients with severe idiopathic constipation. 1989. Gastroenterology 97[4], 932-937Age range 16-78 years (mean>31 years)
Wald. Colonic transit and anorectal manometry in chronic idiopathic constipation. 1986. Archives of Internal Medicine 146[9], 1713-1716Age range 13-68 years (mean>32 years)
Watier et al. Constipation with colonic inertia. A manifestation of systemic disease? 1983. Digestive Diseases and Sciences 28[11], 1025-1033Age range 12-76 years (mean not reported). No subgroups analysis done, no explicit references to children data.
Bannister et al. Physiological studies in young women with chronic constipation. 1986. International Journal of Colorectal Disease 1[3], 175-182Age range 14-53 years (mean 32 years)
Cayan et al. The assessment of constipation in monosymptomatic primary nocturnal enuresis. 2001. International Urology and Nephrology 33[3], 513-516Poor quality study. Not blinded, exclusion criteria unclear. No data on ultrasound. Some data on abdominal X-ray but better quality studies already included in the review
Dimson. Transit time related to clinical findings in children with recurrent abdominal pain. 1971. Pediatrics 47[4], 666-674Use of carmine instead of radioisotope/radiopaque markers to estimate transit time
Dimson. Carmine as an index of transit time in children with simple constipation. 1970. Archives of Disease in Childhood 45[240], 232-235Use of carmine instead of radioisotope/radiopaque markers to estimate transit time
Shankar et al. Colonic Transit Time - What Is Normal? 2004. Journal of Pediatric Surgery 39[2], 166-169United States.Transit time with radiopaque markers conducted in healthy children only with the purpose of contributing normal values
Allen et al. Evaluation of constipation by abdominal radiographs correlated with treatment outcome in children with dysfunctional elimination. 2007. Urology 69[5], 966-969Radiologic findings not related to symptoms of constipation
Orno et al. Sonographic visualization of the rectoanal inhibitory reflex in children suspected of having Hirschsprung disease: a pilot study. 2008. Journal of Ultrasound in Medicine 27[8], 1165-1169Pilot study on trans-perineal ultrasound
The following studies were not reviewed individually as they were already included in the following systematic review on abdominal radiography: Reuchlin-Vroklage et al. Diagnostic value of abdominal radiography in constipated children: a systematic review. 2005. Archives of Pediatrics and Adolescent Medicine 159[7], 671-678
Barr et al. Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children. 1979. Clinical Pediatrics 18[11], 674-679Already included in the systematic review
Leech et al. Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children. 1999. Pediatric Radiology 29[4], 255-258Already included in the systematic review
Rockney et al. The plain abdominal roentgenogram in the management of encopresis. 1995. Archives of Pediatrics and Adolescent Medicine 149[6], 623-627Already included in the systematic review
Beckmann et al. Accuracy of clinical variables in the identification of radiographically proven constipation in children. 2001. Wisconsin Medical Journal 100[1], 33-36United States.Already included in the systematic review
Blethyn et al. Radiological assessment of constipation. 1995. Archives of Disease in Childhood 73[6], 532-533Already included in the systematic review

From: Appendix K, Excluded studies

Cover of Constipation in Children and Young People
Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care.
NICE Clinical Guidelines, No. 99.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010.
Copyright © 2010, National Collaborating Centre for Women's and Children's Health.

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