Utility of plain abdominal radiography in adult ED patients with suspected constipation

Chittineni, Chaitanya; Kartha, Gautham; Cole, Jon B.; Klein, Lauren R.; Rischall, Megan

doi:10.1016/j.ajem.2019.158377

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…[ 6 ] A retrospective study by Driver et al . [ 12 ] revealed that the majority of patients who attended the ED and were subsequently diagnosed and treated for constipation had a normal radiograph with no or minimal stool burden. As such, abdominal radiographs performed in these patients did not play a beneficial role in their management.…”

Section: Discussionmentioning

confidence: 99%

A quality improvement project

Kyriakides¹,

Khamar²,

Khani³

et al. 2022

Journal of Family Medicine and Primary Care

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Background: Inappropriate completion of abdominal radiographs results in unnecessary exposure to ionizing radiation. This quality improvement project aimed to reduce the number of inappropriate abdominal radiographs performed in the emergency department. Materials and methods: Abdominal radiograph request forms were analyzed with reference to the Royal College of Radiologists (RCR) iRefer guidance. A teaching session was then delivered to ED clinicians and posters were disseminated within the department. Post-intervention data collection followed. Results: Following the intervention, there was an increase in the proportion of abdominal radiographs meeting iRefer guidance, which was accompanied by an increased diagnostic yield of these investigations. There was a reduction in the number of requests post-intervention. Conclusions: Our interventions helped increase awareness of both the guidelines and radiation dose associated with each study. Routine education of the iRefer guidelines will help reduce inappropriate requests. This in turn will reduce unnecessary radiation exposure, whilst also reducing the financial burden.

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Section: Discussionmentioning

confidence: 99%

A quality improvement project

Kyriakides¹,

Khamar²,

Khani³

et al. 2022

Journal of Family Medicine and Primary Care

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“…This study reported data exclusively gathered on adult outpatients and did not utilize a formal scoring system to assess fecal burden. The selection of outpatients who reported GI symptoms was a unique aspect of this study compared to other adult studies performed in the emergency room setting [4]. Within this narrower population, the authors did indeed find clinical utility to this test, specifically noting that constipated patients were significantly more likely to have fecal loading compared with diarrhea patients, and that a complaint of bloating was also associated with fecal loading.…”

mentioning

confidence: 82%

Taking a Load Off Diagnosing Constipation: Utility of the Plain Film

Rangan

2019

Dig Dis Sci

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“…It provides only a snapshot of faecal burden dependent on time of last meal and defecation, and provides no dynamic assessment of transit. Its performance in the assessment of constipation is unsatisfactory and its clinical utility questionable [15][16][17]. One study demonstrated a marked disagreement between observers in up to 18% of AXRs viewed [15]; it utilised a formal scoring system [18] for assessing faecal burden demarcating the colon into 3 segments (right colon, left colon and rectosigmoid colon) using anatomic landmarks, with a score of 0-5 in each sector.…”

Section: Abdominal Radiographmentioning

confidence: 99%

Constipation in ulcerative colitis: pathophysiology and practical management

Miller

Emmanuel

Zárate-López

et al. 2020

Frontline Gastroenterol

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Clinical experience suggests that there is a cohort of patients with refractory colitis who do have faecal stasis that contributes to symptoms. The underlying physiology is poorly understood, partly because until recently the technology to examine segmental colonic motility has not existed. Patients are given little information on how proximal faecal stasis can complicate colitis. Treatment guidelines are scanty and many patients are offered little apart from laxatives and advice on increasing fibre intake, which often makes symptoms worse. This article aims to review the history, pathology and management, and create impetus for future research on this underappreciated condition.

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Utility of plain abdominal radiography in adult ED patients with suspected constipation

Cited by 11 publications

References 12 publications

A quality improvement project

A quality improvement project

Taking a Load Off Diagnosing Constipation: Utility of the Plain Film

Constipation in ulcerative colitis: pathophysiology and practical management

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