Norbedo Stefania, Bassanese Giulia, Barbieri Francesca, Barbi Egidio
From the *Institute for Maternal and Child Health-IRCCS "Burlo Garofolo"; and †University of Trieste, Trieste, Italy.
Pediatr Emerg Care. 2017 Oct;33(10):e75-e78. doi: 10.1097/PEC.0000000000001039.
The main aim of the study was to investigate the incidence and the clinically relevant features of functional constipation in patients evaluated for acute abdominal pain in a tertiary care pediatric emergency department.
This is a retrospective study. We analyzed 4394 medical records and recorded the information (demographics, triage code, symptoms, medical history, physical evaluation, laboratory tests, radiological studies, procedures, and treatments) of all patients admitted for acute abdominal pain to the emergency department of the IRCCS Burlo Garofolo, Trieste, during 2010 to 2013.
In this study, a quarter of patients (1020) presenting in the emergency department with acute abdominal pain were affected by functional constipation. Acute pain associated with functional constipation is generally rated from moderate to severe, and the location of the pain on physical evaluation was not a sufficient criterion to guide diagnosis. Isolated vomiting may be present in a minority of cases. Digital rectal exploration was never performed; the majority of patients were treated by means of an enema with prompt relief. Six percent of patients with constipation underwent radiological studies.
This study confirms that the medical history provides a pivotal role in the diagnosis of functional constipation. Digital rectal exploration and x-rays should be avoided in this setting, whereas an enema plays a useful diagnostic and therapeutic role in our study patients.
本研究的主要目的是调查在一家三级医疗儿科急诊科因急性腹痛接受评估的患者中功能性便秘的发病率及临床相关特征。
这是一项回顾性研究。我们分析了4394份病历，并记录了2010年至2013年期间因急性腹痛入住的里雅斯特IRCCS布尔洛·加罗福洛急诊科所有患者的信息（人口统计学、分诊代码、症状、病史、体格检查、实验室检查、放射学检查、操作及治疗）。
在本研究中，急诊科中四分之一（1020例）因急性腹痛就诊的患者患有功能性便秘。与功能性便秘相关的急性疼痛一般为中度至重度，体格检查时疼痛部位不足以作为指导诊断的标准。少数病例可能出现单纯呕吐。从未进行过直肠指检；大多数患者通过灌肠治疗后迅速缓解。6%的便秘患者接受了放射学检查。
本研究证实病史在功能性便秘的诊断中起关键作用。在此情况下应避免直肠指检和X光检查，而灌肠在我们的研究患者中发挥了有益的诊断和治疗作用。
