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Abdominal radiographs are not recommended for evaluation of a primary suspected diagnosis of constipation. In a retrospective cohort study of consecutive pediatric emergency department visits in Toronto, researchers examined 3685 visits in children (age, <18 years; mean, 6.6 years) with discharge diagnoses of constipation.
Overall, 323 patients (9%) returned for evaluation within 7 days and 20 of these children (0.5%) met criteria for misdiagnosis of constipation. New diagnoses at return visits included acute perforated appendicitis (7 cases), intussusception (2), bowel obstruction (2), and 9 single cases of other diagnoses. Nine of the misdiagnosed cases were given enemas at the initial visit. Abdominal x-rays were performed significantly m…