Rationale:
Children presenting with abdominal pain should undergo a thorough medical history, clinical examination, basic blood tests, and fecal calprotectin analysis when inflammatory bowel disease is suspected. Targeted iImaging should be reserved for cases with a specific clinical suspicion, and ultrasound typically provides sufficient diagnostic information. Constipation is a clinical diagnosis; abdominal X-rays are generally of limited value and subject to subjective interpretation.
References:
- Hyams JS, Di Lorenzo C, Saps M, et al. Functional Disorders: Children and Adolescents. Gastroenterology 2016¸ 150: 1456-68.
- Berger MY, Tabbers MM, Kurver MJ, et al. Value of abdominal radiography, colonic transit time, and rectal ultrasound scanning in the diagnosis of idiopathic constipation in children: a systematic review. Journal of Pediatrics 2012; 161(1):44-50.
- Tabbers MM, DiLorenzo C, Berger MY, et al: European Society for Pediatric Gastroenterology H, Nutrition, North American Society for Pediatric G. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr. 2014; 58(2): 258-274.
- Freedman SB, Thull-Freedman J, Manson D, et al. Pediatric abdominal radiograph use,constipation, and significant misdiagnoses. Journal of Pediatrics 2014; 164(1):83-88