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American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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ABSTRACT 

At the present stage of development, one of the most common pathological conditions of the gastrointestinal tract 

(GIT) in children is chronic constipation. Chronic constipation is a serious medical and social problem in all countries of 

the world, due to its wide prevalence, low effectiveness of therapy, reduced social activity, impaired quality of life of 

patients and increased use of healthcare resources. 

KEYWORDS 

Colostasis, independent stool, chronic constipationin children. 

INTRODUCTION 

According to modern literature, from 10 to 40% of 

children in the population suffer from constipation. 

However, it is impossible to establish the true 

frequency of constipation in childhood, because due to 

the low level of medical culture of a part of the 

population and the lack of sanitary propaganda, the 

number of doctors consulting about this remains low 

[2,19,22,24,26]. In most cases, the first complaints of 

constipation appear at the age of 2–4 years, but the 

pathological complex itself begins to form much 

earlier. Very often, not considering constipation in a 

child as a disease, parents independently use enemas, 

laxatives and go to the doctor already with the 

  Research Article 

 

CLINICAL AND RADIOLOGICAL CHARACTERISTICS OF COLOSTASIS IN 

CHILDREN 
 

Submission Date: May 20, 2023, Accepted Date:  May 25, 2023,  

Published Date: May 30, 2023  

Crossref doi: https://doi.org/10.37547/ajbspi/Volume03Issue05-07 

 

 

Raupov F.S. 
Bukhara State Medical Institute, Bukhara, Uzbekistan 

 

Journal Website: 

https://theusajournals.

com/index.php/ajbspi 

Copyright: Original 

content from this work 

may be used under the 

terms of the creative 

commons attributes 

4.0 licence. 

 

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Volume 03 Issue 05-2023 49 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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development of certain complications of the disease 

[1,12,18,21,23,25]. 

Despite the fact that in 95% of cases chronic 

constipation is initially functional in nature and can be 

stopped by non-drug methods, late seeking medical 

help, the patient's unwillingness to change the nature 

of nutrition and physical activity, low patient 

confidence in therapy lead to decompensation and the 

formation of organic pathology of the colon. intestines 

[3,7,14,21,27,28]. Long-term retention of contents in 

the intestine adversely affects the development of the 

child, contributes to the occurrence of various 

complications and diseases of the colon [4,9,15,20]. 

According to some authors, 35% of girls and 55% of boys 

aged 6 to 12 suffering from constipation develop anal 

incontinence (encopresis), which can lead to their 

social exclusion. According to the clinical observations 

of some authors, very often a misunderstanding of the 

concept of "constipation" only as "rare defecation" 

leads to late seeking medical help already at the stage 

of decompensation with the development of 

complications [5,11,16,17]. Full intestinal peristalsis is 

the result of the functioning of the enteric nervous 

system, muscles and connective tissue. Malfunction of 

any of these components leads to a violation of 

peristalsis, which can cause constipation in children 

[8,10,17,29]. 

When analyzing the literature data, there is quite a lot 

of material on the problems of constipation in children, 

but they do not have a systematic, complete review 

and analysis. To this day, there are no clear indications 

for surgical treatment of colostasis, the timing of the 

operation, the problem of determining clear 

indications and contraindications for the operation has 

not been resolved. Surgeons in carrying out 

interventions are based on their own experience and 

knowledge gleaned from well-known literary sources. 

That is why, there are still a large number of intra- and 

postoperative complications, there are no standards 

for the care of patients before and after surgical 

interventions.[6,15,17].There are no diagnostic, clinical 

criteria for colostasis in the age aspect in children, 

which determine the relevance of conducting in-depth 

experimental and clinical studies in this direction. 

Purpose of the study. The study of the features of the 

clinical and radiological picture of chronic colostasis in 

children. 

Materials and research methods.INThe basis of this 

work included data from the examination and 

treatment of 149 sick children aged from 1 month to 14 

years with colostasis. The analysis of patients who 

received treatment in the Department of Pediatric 

Surgery of the Bukhara Regional Children's 

Multidisciplinary Medical Center for the period 2020-

2023 was carried out. The main criterion for inclusion of 

patients in our study was the presence of colostasis, 

patients' complaints about the lack of independent 

stool. The work does not include patients with the total 

form of Hirschsprung's disease. 

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Volume 03 Issue 05-2023 50 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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All children underwent a comprehensive examination 

used in pediatric surgery, including clinical and 

laboratory, x-ray studies: detailed study and history 

taking, clinical objective examination, if necessary, 

rectal digital examination; general clinical tests - a 

general analysis of blood, feces and urine; X-ray 

contrast study - irrigography of the colon with a 

solution of barium sulfate according to the method of 

A.I. Lenyushkin. 

Discussion of results.According to our data, of the 

currently existing research methods, polypositional 

irrigography is the most accessible, valuable and 

reliable for optimizing the diagnosis of colostasis in 

children. When it was used at the time of batch filling 

of the contrast, all sections of the large intestine were 

filled with contrast and a series of images were taken 

in different positions (position) of the patient: lying on 

his back, standing, on the right and left side, and after 

emptying the contrast. 

This allows you to determine the physiological state, 

the presence of additional bends, elongation, 

incomplete fixation, rotation and rigidity of the colon, 

which allows you to determine the degree of violation 

of transient function. 

Dolihosigma according to A.I. Lenyushkin is diagnosed 

in 15% of healthy children, taking into account the 

elongated multi-loop or two-loop sigmoid colon, when 

the loops are located in the abdominal cavity, reaching 

the splenic or hepatic flexure of the colon. In this case, 

the intestine is excessively mobile, freely moves in the 

abdominal cavity, additional loops remain after bowel 

emptying. 

A common cause of sub- and decompensated forms of 

colostasis in children is the rare appeal of the parents 

of a sick child to a specialist at an early stage of the 

disease, the lack of awareness of general practitioners, 

pediatricians, gastroenterologists and pediatric 

surgeons in primary and secondary health care about 

early diagnosis and treatment of the disease. 

Sometimes, as a result of prolonged and excessive 

drug treatment of patients with an incorrect diagnosis, 

without x-ray examination and pathogenetic 

justification, by a general practitioner or 

gastroenterologists, the patient receives symptomatic 

and unreasonable treatment. On the other hand, 

pediatric surgeons, leaning toward the diagnosis of 

Hirschsprung's disease, resort to surgical treatment, 

which cannot be considered pathogenetically 

substantiated. 

Therefore, in our opinion, it is reasonable to conduct an 

X-ray contrast study with a solution of barium sulfate - 

irrigography of the colon in sick children suffering from 

constipation. Irrigography is a mandatory study in all 

children with suspected constipation. The sensitivity 

and specificity of the method, according to some 

literature data, reaches up to 90%, respectively. The 

timing of the X-ray examination depends on several 

factors, the main of which is the efficiency of emptying 

the colon. It is advisable to perform the examination 

not immediately after the patient's admission to the 

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Volume 03 Issue 05-2023 51 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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hospital, but delayed, after stopping the effects of 

fecal intoxication. 

In order to study the anatomical and physiological 

state of the colon, radiopaque irrigography is 

performed, which makes it possible to assess the 

evacuation function of the colon and the presence of 

its structural changes. By the nature of the evacuation 

of the contrast agent, the contour of the intestine, the 

state of the haustra (increased or smoothed) and the 

presence of spasm (local or total), one can speak of a 

hypotonic, atonic or spastic condition of the colon. 

This well-studied and long-used method of 

examination makes it possible to establish the correct 

diagnosis in most cases. However, the known 

radiological criteria do not always allow to do this 

accurately enough in the group of children with chronic 

colostasis, where dolichocolon, functional 

constipation, Hirschsprung's disease are most 

common. 

Dolichocolon has specific features in the form of 

additional loops of the large intestine, often extending 

beyond its anatomical zone. The diagnosis of 

functional constipation is established in the presence 

of a uniform expansion of the distal colon, with the 

exclusion of other causes that cause colostasis. 

For long forms of Hirschsprung's disease, the most 

characteristic is the presence of a narrowed 

aganglionic zone, suprastenotic expansion and a 

funnel-shaped transition zone. At the same time, the 

reliability of X-ray examination is 80%, and in 

Hirschsprung's disease with a supershort segment, it 

exceeds 20%. To assess the condition of the mucous 

membrane of the colon, an endoscopic examination 

(rectoscopy, colonoscopy) with targeted biopsy for 

histological and, if necessary, histochemical analysis is 

indicated. They allow you to identify acute and chronic 

inflammatory diseases of the colon, determine the 

stage of the disease, and evaluate the effectiveness of 

treatment. 

Histochemical study of cholinesterase activity is 

necessary in the differential diagnosis of 

Hirschsprung's disease from functional megacolon, in 

which this reaction is negative. 

Currently, in the literature there are such terms as 

"dolichosigma", "megadolichosigma", "megasigma", 

"dolichocolon", etc., which are used to refer to 

supposedly independent nosological forms, which only 

creates confusion in the terminology and assessment 

of the lesion. Dynamic observation with X-ray control 

allows in some cases to note the appearance of 

dilatation of the lumen of the sigmoid colon, which was 

not previously observed in this patient. There is a 

certain relationship between an increase in the lumen 

of the sigmoid colon and the duration of persistent 

constipation. This suggests that the occurrence of 

dilatation is not a new form of the disease, but 

represents the progression of dysfunction of the 

sigmoid colon in dolichosigmoid. 

The patient's irrigogram shows (Fig. 1) a two-loop 

dolichocolon with dilatation of the colon, 

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Volume 03 Issue 05-2023 52 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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transversoptosis with a bend of the splenic angle. 

Figure 2 shows colonic expansion with dilatation 

throughout, a “multi-loop” kink that forms acute 

angles, and radiographic evidence of transversoptosis 

with a 180-degree kink in the splenic angulation. 

 

 

 

Fig.1. Dolichocolon, "two-loop" with dilation  Fig.2. Dolichocolon, "multi-loop" with 
dilation 

 

The following figures (Fig. 3 and 4) show a single-loop 

dolichocolon with dilatation of the colon, 

transversoptosis with a bend in the splenic angle. The 

drawings show the expansion of the colon with 

dilatation along its entire length, a “one-loop” bend 

that forms acute angles, and there are also radiological 

signs of transversoptosis with a bend in the splenic 

angle by 180 degrees. 

  

Fig.3. Dolichocolon, "one-loop" with 
dilatation, bending of the splenic 
angle 

Fig.4. Dolichocolon, "single-
loop" with dilatation bending 

of the splenic angle 
 

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Volume 03 Issue 05-2023 53 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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These radiographic criteria in patients with sub- and compensatory courses of dolichosigmoid were evaluated in a 

point system, which is important for optimizing indications for surgical treatment (Table No. 1). 

Criteria for evaluating polypositional irrigography to optimize indications for surgical treatment of colostasis in 

children 

Table 1 

 

Curvature of the colon 

Condition of the corners of the colon (in degrees) and 
scores (in points) 

with irrigography 

Normal angles (75° 
<) 

(1 point) 

sharp corners 
(25-75°) 

(2 points) 

Too sharp corners 
(25°>) (3 points) 

anorectal 20 2 3 

Recto-sigmoid 1 2 3 

Sigmoid-decendal 1 2 3 

Splenic 1 2 3 

Hepatic 1 2 3 

Additional loops 1 2 3 or more 

Points 6 12 18 and over 

 

When interpreting the data obtained, we took into 

account the sum of points scored during polypositional 

irrigography, as well as during the collection of 

anamnesis and objective clinical examination, as well 

as on the basis of general clinical, laboratory, rectal 

examinations. 

Those patients with a total score of more than 6 points 

underwent complex conservative treatment. If the 

total score was over 12, we performed multiple (3 or 

more times) complex conservative treatment, and if it 

was ineffective, we determined the relative indications 

for surgical treatment. The total score was over 18, not 

only the pathology of the colon was often detected, 

but also other defects in the form of a violation of the 

fixation of the pelvic floor muscles with clinical 

complete disorders of the motor-evacuation function 

of the colon, was determined as a direct indication for 

surgical treatment. At the same time, many issues of 

conservative treatment in 149 sick children who came 

to us with different genesis of colostasis, issues of 

conservative treatment were resolved jointly with a 

gastroenterologist, nutritionist, endocrinologist, 

neuropathologist. 

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Volume 03 Issue 05-2023 54 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

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Based on the above data, we have developed an 

approximate management scheme (algorithm) for sick 

children with colostasis. Of the 149 patients examined, 

131 (88.0%) patients were treated conservatively, the 

remaining 18 (12.0%) patients were treated surgically. In 

the long-term period of treatment, the condition of the 

patients is satisfactory, no complication was observed. 

CONCLUSION 

Thus, the assessment of the clinical and radiological 

characteristics of patients with constipation in children 

makes it possible to determine the indications for 

conservative and surgical treatment tactics. The 

conditions for the effectiveness of the prevention and 

treatment of constipation, improving the quality of life 

of sick children is the interaction of the doctor and the 

patient in choosing the timing of surgical correction, 

suitable for each individual child with organic 

constipation, as well as the optimal management 

tactics for functional constipation. 

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American Journal Of Biomedical Science & Pharmaceutical Innovation    
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VOLUME 03 ISSUE 05     Pages: 48-57 

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American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
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Volume 03 Issue 05-2023 57 

                 

 
 

   
  
 

American Journal Of Biomedical Science & Pharmaceutical Innovation    
(ISSN – 2771-2753) 
VOLUME 03 ISSUE 05     Pages: 48-57 

SJIF IMPACT FACTOR (2021: 5. 705) (2022: 5. 705) (2023: 6.534) 
OCLC – 1121105677     

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Publisher: Oscar Publishing Services 

Servi 

autoimplantation in the dynamics of 

observation, // EUROPEAN JOURNAL OF 

MODERN MEDICINE AND PRACTICE. - 2022. - 

Vol. 2 no. 3: EJMMP. C. 40-45 in Russian] 

31. 31. Хидоятов, Б. А. Микроциркуляторное 

русло кишечника и поджелудочной железы и 

его особенности при экспериментальном 

сахарном диабете / Б. А. Хидоятов, А. Т. 

Ахмедов // Морфология. – 2008. – Т. 133. – № 

2. – С. 145-146. – EDN JUTXTT.7. Otto 

CM, Pearlman AS Textbook of clinical 

echocardiography. Philadelphia: WB Saunders 

Co.; 1995:418. 

32. Obidovna, D. Z., & Sulaimonovich, D. S. (2023). 

Influence of the Mode of Work and Recreation 

of the Student's Health. INTERNATIONAL 

JOURNAL OF HEALTH SYSTEMS AND MEDICAL 

SCIENCES, 2(3), 3-5. 

33. Obidovna, D. Z., & Sulaymonovich, D. S. (2023). 

Forming a Healthy Lifestyle for Students on the 

Example of the Volleyball Section in 

Universities. EUROPEAN JOURNAL OF 

INNOVATION IN NONFORMAL EDUCATION, 

3(3), 22-25. 

34. Джалилова, З. О., Хасанов, К. А., & Султонов, 

А. А. (2021). Роль научного управления в 

процессе обучения 

высококвалифицированных врачей в новом 

Узбекистане. Молодой ученый, (26), 377-379. 

 

 

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