Diagnostic value of plain abdominal radiography in stroke patients with bowel dysfunction

Abstract

Objective: To evaluate the diagnostic value of plain abdominal radiography in stroke patients with bowel dysfunction.

Methods: A total of 59 stroke patients were recruited and assigned into constipation or non-constipation group. Patients were interviewed to obtain clinical information, constipation score, and Bristol stool form scale. The total and segmental colon transit time (CTT) was measured using radio-opaque markers (Kolomark). The degree of stool retention was evaluated by plain abdominal radiography and scored by two different methods (Starreveld score and Leech score). The relationship between the clinical aspects, CTT, and stool retention score using plain abdominal radiography was determined.

Results: Average constipation score was 4.59±2.16. Average Bristol stool form scale was 3.86±1.13. The total and segmental CTTs showed significant differences between the constipation and non-constipation groups. There was statistically significant (p<0.05) correlation between the total CTT and constipation score or between Starreveld score and Leech score. Each segmental CTT showed significant correlation (p<0.05) between segmental stool retention scores.

Conclusion: The stool retention score showed significant correlation with constipation score as well as total and segmental CTT. Thus, plain abdominal radiography is a simple and convenient method for the evaluation of bowel dysfunction in stroke patients.

Keywords: Abdominal radiography; Colon transit time; Constipation; Stroke.

Fig. 1. The comparison of constipation score and Bristol stool form scale in the constipation and the non-constipation groups. Values were presented as mean±standard deviation. ^*p<0.05, significant difference between the constipation and the non-constipation groups.

Fig. 2. Starreveld score (A) and Leech score (B) on each segment were evaluated by plain abdominal radiography.

Fig. 3. The inter-inspector reliability on Starreveld score (A) and Leech score (B) was represented by scatter diagrams. There was a statistically significant correlation between the interpretations of inspectors (r=0.953, r=0.905).

Fig. 4. Scatter diagrams of the correlation between the total colon transit time (CTT) and Starreveld score, between the total CTT and Leech score. There was statistically significant correlation between each method (r=0.555, r=0.564).