{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:29:29Z","timestamp":1792636169305,"version":"4.5.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"13","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Functional constipation is common in children and accurate diagnostic methods are essential for early diagnosis and effective management. The diagnostic accuracy of transabdominal ultrasound to diagnose functional constipation is unclear.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To evaluate the diagnostic accuracy of transverse rectal diameter measurement via transabdominal ultrasound in diagnosing children with functional constipation and in identifying fecal impaction.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Electronic databases were searched from inception to March 2023. Original studies investigating the diagnostic accuracy of measuring transverse rectal diameter via transabdominal ultrasound, including children with and without functional constipation, or with and without fecal impaction were included. Data extraction and quality assessment were performed independently by two reviewers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Sixteen studies were included (<jats:italic>n<\/jats:italic>\u2009=\u20091,801 children, 0\u201317\u00a0years). Thirteen studies investigated the diagnostic accuracy for functional constipation, and five for fecal impaction. High risk of bias was found across the majority of studies mainly due to un-blinded case\u2013control designs. Cut-off transverse rectal diameter values to diagnose functional constipation ranged from 2.4\u00a0cm to 3.8\u00a0cm. Meta-analysis (seven studies, <jats:italic>n<\/jats:italic>\u2009=\u2009509 children) estimated mean sensitivity and specificity to diagnose functional constipation were 0.68 (95% confidence interval (CI) 0.55\u20130.78) and 0.81 (95% CI 0.71\u20130.88), respectively. Meta-analysis of diagnostic accuracy of identifying fecal impaction was not feasible. Studies reported a sensitivity and specificity ranging between 68\u2013100% and 83\u2013100%, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Transabdominal ultrasound may be a valuable non-invasive diagnostic tool to diagnose functional constipation by measuring transverse rectal diameter and identifying fecal impaction in children. Heterogeneous study methods and lack of age-dependent normal values impair current clinical recommendations. Future research should focus on separating age groups and developing a standardized protocol.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00247-024-06083-4","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T08:19:25Z","timestamp":1731658765000},"page":"2227-2242","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Accuracy of transabdominal ultrasound to diagnose functional constipation and fecal impaction in children: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"54","author":[{"given":"Johanna M. B. 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Benninga is consultant for Mallinckrodt, Shire, Danone, FrieslandCampina, HIPP, Norgine, Coloplast, United\u00a0Pharmaceuticals, and Wellspect. All honoraria were paid to the hospital (Amsterdam UMC).\u00a0Ilan J.N. Koppen received research funding from Wellspect Healthcare and The EuroQol Research Foundation. All\u00a0other authors declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}