Translations:Constipation (peds)/13/en

Stool burden that may be consistent with constipation on KUB. Use of a KUB to diagnose constipation in pediatric patients is generally NOT indicated, as other serious pathology may also result in the imaging findings.

Use of a KUB to diagnose constipation in pediatric patients is generally NOT indicated, as acute appendicitis and other serious pathology may also result in increased stool burden. If the abdominal exam is concerning, proceed to ultrasound/CT.

• In many cases, may require no workup and diagnosis can be made clinically
• Consider digital rectal exam
  • Although generally not necessary, this may be done to assess for organic causes or to assess for disimpaction success
• Consider abdominal labs
  • CBC
  • Chemistry (hypokalemia or hypercalcemia)
  • LFTs + lipase
  • Coagulation studies (PT, PTT, INR), as a marker of liver function
• Consider TSH if concern for hypothyroid related constipation
• Consider diagnostic imaging
  • Constipation should not cause abdominal tenderness on exam
  • Ultrasound if concern for intussception, biliary pathology, and/or beginning of appendicitis workup
  • CT abdomen/pelvis with IV contrast if concern for surgical abdomen
    • CT may show stool burden in colon/rectum