Department of Paediatrics, Sahlgrenska Academy, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden.
Department of Paediatric Surgery, Queen Silvia Children's Hospital, Gothenburg, Sweden.
J Paediatr Child Health. 2023 Sep;59(9):1021-1027. doi: 10.1111/jpc.16447. Epub 2023 May 30.
Transabdominal rectal ultrasound (TRU) is used to measure transverse rectal diameter (TRD) in order to diagnose functional constipation (FC) and megarectum, and to evaluate treatment. The proposed cut-off value is 3.0 cm. Currently, no standardised values exist for children below the age of 4. We used repeated TRUs to establish reference TRD values in healthy infants and to describe rectal diameter in infants with FC.
This prospective observational cohort study enrolled healthy term babies from a maternity department. TRD measurements were taken at 2 and 12 months of age, and questionnaires completed in interviews helped diagnose FC according to Rome III criteria.
Two hundred TRUs were performed on 110 infants (62 males). In infants without FC anytime, the mean TRD at 2 months was 1.56 (SD 0.32) cm and at 12 months 1.78 (0.47) cm, while the 95th percentiles were 2.26 and 2.64 cm, respectively. In 77 infants with two TRUs, the mean increase was 0.21 cm (95% confidence interval: 0.099-0.318). Thirteen infants were diagnosed with FC during the study period. At 2 and 12 months of age, there was no difference in TRD between infants with and without FC.
TRD increased from 2 to 12 months. We suggest 2.3 cm as an upper limit for normal TRD at 2 months and 2.6 cm at 12 months. Infants diagnosed with FC did not have a greater TRD than infants without, either before or after treatment. Further studies are needed to evaluate the usefulness of TRU in infants with FC or megarectum.
经腹直肠超声（TRU）用于测量直肠横径（TRD），以诊断功能性便秘（FC）和巨直肠，并评估治疗效果。目前建议的截断值为 3.0cm。目前，4 岁以下儿童尚无标准化值。我们使用重复 TRU 为健康婴儿建立参考 TRD 值，并描述 FC 婴儿的直肠直径。
本前瞻性观察队列研究纳入了来自产科病房的健康足月婴儿。分别在 2 个月和 12 个月龄时进行 TRD 测量，并通过访谈完成问卷，根据罗马 III 标准诊断 FC。
110 名婴儿（62 名男性）共进行了 200 次 TRU。在任何时候均无 FC 的婴儿中，2 个月时的平均 TRD 为 1.56cm（标准差 0.32cm），12 个月时为 1.78cm（0.47cm），第 95 百分位数分别为 2.26cm 和 2.64cm。在 77 名进行了两次 TRU 的婴儿中，平均增加量为 0.21cm（95%置信区间：0.099-0.318cm）。在研究期间，有 13 名婴儿被诊断为 FC。在 2 个月和 12 个月龄时，FC 婴儿与无 FC 婴儿的 TRD 无差异。
TRD 从 2 个月到 12 个月逐渐增加。我们建议 2 个月时正常 TRD 的上限值为 2.3cm，12 个月时为 2.6cm。在治疗前后，无论是 FC 婴儿还是无 FC 婴儿，其 TRD 均无差异。需要进一步研究来评估 TRU 在 FC 或巨直肠婴儿中的有用性。
