Imaging of Constipation and Its Complications

Abstract

Radiology is an important tool in the diagnosis and treatment of patients with constipation. Imaging provides both vital anatomic and functional information that may facilitate arriving at an accurate diagnosis, assessing for serious complications, and delivering the appropriate therapy in a timely fashion. In this chapter, we discuss how each imaging modality is used to image patients with constipation. Within this discussion, we review what information is provided by each modality and we detail complete imaging protocols and technical parameters for each test. Finally, we highlight key findings with illustrative images from radiography, fluoroscopy, CT, and MR imaging.

Chaudhuri’s Dashboard of Vitals in Parkinson’s syndrome: an unmet need underpinned by real life clinical tests

“…Constipation is a clinical diagnosis although imaging such as abdominal XR and CT scans can be used to demonstrate its severity. Radiological findings of constipation can include evidence of fecal loading throughout the colon, luminal faecalomas, with or without reduction of luminal gas ( 147 ). Furthermore, abdominal XR or CT helps in the diagnosis of pseudo-obstruction showing dilation of the colon, with or without other associated radiological features such as a volvulus-sign and is strongly recommended in advanced PD cases, particularly when screening for intrajejunal levodopa infusion therapies ( 105 ).…”

Imaging of Gastrointestinal Tract Ailments

“…It can be used to assess the extent of the rectal obstruction in addition to aiding in finding the cause. This method is usually used in adult and adolescent patients, who can follow the instructions for the dynamic part of the workup [ 251 ]. Fluoroscopic images of the pelvic floor are obtained when the muscles are at rest, followed by when they are contracting.…”

“…Although the use of digital fluoroscopy dramatically reduces the patient’s exposure to radiation, this imaging technique is not usually tolerated well by patients, and it is unable to detect soft-tissue structures [ 252 ]. Another fluoroscopic imaging method used in the diagnosis of constipation is contrast enema, which can provide information about the luminal size of the colon and rectum, the length of involvement, and site(s) of transition in luminal caliber [ 251 ]. This method may have both diagnostic and therapeutic effects on constipation, as the contrast agent instilled into the colon and rectum may help reduce fecal impaction [ 251 ].…”

“…Another fluoroscopic imaging method used in the diagnosis of constipation is contrast enema, which can provide information about the luminal size of the colon and rectum, the length of involvement, and site(s) of transition in luminal caliber [ 251 ]. This method may have both diagnostic and therapeutic effects on constipation, as the contrast agent instilled into the colon and rectum may help reduce fecal impaction [ 251 ].…”

“…Computed tomography (CT) is the most important imaging method for accessing patients with known or suspected constipation, especially adult patients. In some cases, CT can also be used in the diagnosis of pediatric patients with constipation via modulating radiation dose [ 251 ]. It is readily available, quickly performed, permits the evaluation of latent complications, and allows for structural visualization for extra-colon [ 251 ].…”