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686 Nuclear Transit Scintigraphy (Nts) - An Evolving Role from Diagnostic to Monitoring Tool in Children With Chronic Constipation
  1. YI Yik1,2,3,
  2. DJ Cook4,
  3. DM Veysey4,
  4. CF Tudball4,
  5. BS King4,
  6. KA Morris4,
  7. TM Cain4,
  8. BR Southwell3,
  9. JM Hutson2,3,5
  1. 1Department of General Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  2. 2Department of Paediatrics, University of Melbourne
  3. 3Gut Motility and Research Laboratory, Murdoch Children’s Research Institute
  4. 4Department of Biomedical Imaging
  5. 5Department of Urology, Royal Childrens Hospital Melbourne, Melbourne, VIC, Australia

Abstract

Purpose Nuclear transit scintigraphy (NTS) is a relatively new investigation for children with intractable chronic constipation. Three patterns of colonic transit were identified: normal, slow and rapid colonic transit. We aimed to determine the use of NTS over the last 12 years at a tertiary institute. We hypothesised that NTS has evolved from a diagnostic to a monitoring tool.

Methods NTS were reviewed retrospectively (1999–2011) and characterized based on 3 different colonic transit patterns with further division into a new/repeat study (Ethics30059A). Statistical analysis was performed with Chi-square test to examine the effect of change; p<0.05 considered significant. Transcutaneous electrical stimulation (TES) was introduced to treat slow-transit constipation (STC) since 2006. Hence, we examined the changing role of NTS before and after TES use in STC children.

Results From 1999–2011, there were 955 NTS performed (667 new and 288 repeat studies): normal colonic transit - 133 new and 27 repeat; rapid colonic transit - 190 new and 24 repeat; slow colonic transit - 344 new and 237 repeat studies; with more repeat studies for STC children (p<0.0001, Chi-square). There was an increase of repeat studies from 1999–2005 (15%) to 2006–2011 (30%, p<0.0001). Since 2006, 95/237 (40%) NTS performed were repeat studies to monitor the effects of TES in STC children.

Conclusion NTS has is a useful diagnostic tool and helps to improve management of chronic constipation by guiding therapy, targeting the underlying dysmotility. It also provides objective assessment in monitoring response to therapy/intervention.

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