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. 2015 May 23;9(3):388-94.
doi: 10.5009/gnl13414.

Sonographic evaluation of gallbladder motility in children with chronic functional constipation

Rakesh Mehra  1 , Kushaljit Singh Sodhi  1 , Akshay Saxena  2 , B R Thapa  3 , Niranjan Khandelwal  1
Affiliations

Sonographic evaluation of gallbladder motility in children with chronic functional constipation

Rakesh Mehra et al. Gut Liver. .

Abstract

Background/aims: Studies in adults suggest that constipation may not be a purely colonic pathology and may be a component of a generalized gastrointestinal (GI) motor disorder in which proximal GI motility can be impaired. Pediatric data are scarce, and the natural history of the disorder remains undefined. We aimed to evaluate gallbladder motility in a subset of Asian children with chronic functional constipation.

Methods: Abdominal ultrasound was performed on 105 children, including 55 patients (aged 3 to 13 years) with chronic functional constipation who met the inclusion criteria and 50 age- and gender-matched controls. The gallbladder contractility index was calculated based on the preprandial and postprandial gallbladder areas. Preprandial and postprandial values for gallbladder volume and wall thickness were evaluated.

Results: The mean value of the contractility index for the patients (15.77±24.68) was significantly lower than the mean value for the controls (43.66±11.58) (p=0.001). The mean postprandial gallbladder volumes and areas were larger in children with gallbladder hypomotility (p<0.05). The mean duration of constipation (4.8 months) was significantly higher (p=0.004) in the children with gallbladder hypomotility.

Conclusions: Gallbladder motility is significantly impaired in children with chronic functional constipation. This study contributes to the understanding of the underlying pathophysiology, which will enable advancement in and improved management of children with chronic constipation and associated gallbladder hypomotility.

Keywords: Children; Constipation; Gallbladder; Motility; Ultrasound.

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Figures

Fig. 1
Fig. 1
Ultrasound evaluation of gallbladder volume using Dodd’s formula in the preprandial (A) and postprandial (B) states in a control child. Distances 1, 2, and 3 represent gallbladder length, width, and height, respectively. The contractility index was 68.8%.
Fig. 2
Fig. 2
Region-of-interest indicates the gallbladder cross-sectional area. Preprandial (A) and postprandial (B) ultrasounds in a 3-year-old child with constipation. The contractility index (CI) was 7.6% (CI, <25%).
Fig. 3
Fig. 3
Ultrasound evaluation of gallbladder wall (anterior) thickness.
See this image and copyright information in PMC

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