Association between abdominal pain and fecal impaction grade assessed through radiography in constipated patients at a pediatric emergency service. / Asociación entre el dolor abdominal y el grado de coproestasis mediante la evaluación radiográfica en pacientes estreñidos que acuden a los servicios de urgencias pediátricas.

INTRODUCTION AND AIM: Abdominal pain in children is a frequent cause of emergency room consultation. An important group of those patients presents with chronic constipation and fecal impaction. Plain abdominal x-ray is widely used for making a diagnosis and ruling out the need for surgical treatment. The present study examined the association between pain intensity and fecal impaction grade. MATERIALS AND METHODS: An analytic cross-sectional study was conducted that compared 2 radiographic scales to determine the association between the grade of fecal impaction observed and abdominal pain intensity in patients that sought medical attention at an emergency service within a 7-month period. The analysis was carried out by 2 different observers, utilizing 2 different radiographic scales to confirm their reproducibility. The degree of interobserver agreement was measured using the Kappa coefficient and the association between abdominal pain and fecal impaction grade was measured through the Spearman correlation coefficient. RESULTS: There was a significant association between pain intensity and the radiographic grade of fecal impaction (P<.05) for the radiographic scale by segments and its interobserver agreement was high, compared with the scale by percentage. CONCLUSIONS: Radiographic scales may be useful in the evaluation and treatment of patients with abdominal pain and constipation. The segmental scale showed less interobserver variability, suggesting its proposal as an alternative in the evaluation and follow-up of patients with chronic constipation.