Evaluation of Splanchnic Blood Flow Using Doppler Ultrasound Before and After Constipation Treatment in Patients with Bladder and Bowel Dysfunction

Abstract

Purpose: To evaluate the correlation between blood flow dynamics using conventional and Doppler ultrasound (US), and to assess the rectosigmoid ratio ultrasonographically in children with suspected bladder and bowel dysfunction (BBD). Methods: This prospective study was conducted between January 2023 and January 2024 involving 62 children aged 5–18 years. Ultrasound were used to measure peak systolic velocity (PSV), pulsatility index (PI), resistive index (RI) of arteries, and the rectosigmoid ratio (R/S). Behavioral therapy and osmotic laxative treatment were administered for 3 months, followed by reassessment. Results: Before treatment, the study group had a mean rectal diameter of 18 ± 15.5 mm, which increased to 23.5 ± 14.25 mm post-treatment (p = 0.008). The mean sigmoid colon diameter was 18.5 ± 10 mm before treatment and 18 ± 5 mm after treatment (p = 0.004). The rectosigmoid ratio (R/S) increased from 0.97 ± 0.76 to 1.27 ± 0.65 post-treatment (p = 0.036). No significant differences were found in the aortic, CA, and SMA flow velocities, PI, and RI between the groups or pre- and post-treatment within the study group. However, patients with an R/S index ≥1 had lower celiac PSV values compared to those with an R/S index <1 (p = 0.009). Conclusion: Doppler ultrasound evaluation of intestinal blood flow did not show significant clinical benefits, it may offer insights for future research. Noninvasive measurement of the rectosigmoid index is useful in diagnosing and planning treatment for constipation, especially in cases with diffuse motility problems rather than fecal impaction.