Abstract
Purpose: The prognosis of chronic constipation in children is generally good, and most children show improvement of their defecation following treatment by glycerin enema and laxative administration. Children resistant to long-term conservative therapy and having almost no natural bowel movement except by glycerin enema were evaluated by 3D-CT for vertebral arch dysraphism.
Methods: From 2003 to 2011, we performed barium enema examination and anorectal manometry on 157 children with severe constipation and suspected of having Hirschsprung disease. Six of these children were diagnosed as having Hirschsprung disease or pseudo-Hirschsprung disease. The remaining 151 were diagnosed as having chronic constipation and were treated conservatively, among which 20 (13.2%) were found to be resistant to conservative treatment. These children showed almost no natural bowel movement except when induced by glycerin enema, and they underwent lumbar 3D-CT. They were compared with 29 nonconstipation children who underwent abdominal CT to examine for appendicitis, intussusception, neuroblastoma, or other diseases.
Results: Dysraphism of the vertebral arch was found at L5 and S1 in 55.0% and 90.0% of the children in the severe constipation group compared with 3.4% and 34.5% of those in the nonconstipation group, respectively.
Conclusions: The percentages of children with L5 and S1 dysraphism of the vertebral arch were significantly higher in the severe chronic constipation group than in the nonconstipation control group.
