Imaging

Constipation

Preliminary Diagnosis: Constipation

I. What imaging technique is first-line for this diagnosis?

Plain radiography of the abdomen.

II. Describe the advantages and disadvantages of this technique for diagnosing constipation.

Advantages

  • Quick.

  • Inexpensive imaging modality.

  • Exposes the patient to negligible radiation.

Disadvantages

  • Less sensitive and specific in evaluating for any potential bowel obstruction location and/or etiology compared to CT.

  • Less adept in evaluating the endolumen of the bowel for any underlying lesions resulting in constipation or bowel obstruction.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist. Consent may be required at some institutions for pregnant women.

IV. What alternative imaging techniques are available?

CT abdomen and pelvis with PO and IV contrast.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing constipation.

Advantages

  • The focal area of abnormality resulting in constipation or bowel obstruction may be determined with great specificity and sensitivity.

  • Adept to evaluate for any specific bowel pathology, such as an underlying mass or stricture.

Disadvantages

Exposes the patient to a large amount of ionizing radiation

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.

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