BARIUM ENEMA: IS IT IMPORTANT IN THE EVALUATION OF CHILDHOOD CONSTIPATION

We question the importance of barium enema (BE) in the evaluation of childhood constipation. The radiographic appearance of a transition zone (TZ) or delayed evacuation of barium (DEB) on BE necessitates a second procedure, rectal suction biopsy (RSB). RSB is performed to confirm the presence of submucosal ganglion cells and rule out Hirschsprung's disease (HD). To determine if RSB alone is sufficient to evaluate the child with constipation, we retrospectively reviewed the charts of 76 children (1day-18yrs) with constipation who had BE & RSB. BE were reviewed for TZ, DEB and/or other colonic anatomic abnormalities (CAA). Seven children (9%) had CAA; 5 neonates (under 1 wk of age) with microcolon and 2 infants with previous history of NEC had colonic strictures. TZ was present in 23 patients (30%) and DEB in 26 patients (34%). Results of RSB are presented below: