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AJR Teaching File: Child with Chronic Constipation

Wessam B. Bou-Assaly1, Anna Illner, Lisa Delaney and Richard Gunderman

1 All authors: Department of Radiology, Indiana University School of Medicine, 6833 Walnut Bend Rd., Indianapolis, IN 46254.


Figure 1
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  		Fig. 1A —8-year-old boy with chronic constipation. Barium enema shows impacted stool (arrow) filling the sigmoid colon and rectum.

 

Figure 2
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  		Fig. 1B —8-year-old boy with chronic constipation. Pelvic radiograph shows sacral abnormalities (arrow) with distal sacral dysplasia taking the shape of a scimitar.

 

Figure 3
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  		Fig. 1C —8-year-old boy with chronic constipation. Unenhanced axial T1 MRI image shows sacral hypoplasia with associated presacral bilobulated T1 hypointense mass lesion (arrow), whose signal is identical to intrathecal CSF signal.

 

Figure 4
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  		Fig. 1D —8-year-old boy with chronic constipation. Axial T2 MR image also shows bilobular, well-defined, hyperintense presacral mass lesion (arrow). Markedly distended rectosigmoid colon is obvious on this sequence.

 

Figure 5
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  		Fig. 1E —8-year-old boy with chronic constipation. Unenhanced sagittal T1 and sagittal T2 images give lateral view of lesion (arrow), which appears homogenous with low T1 and high T2 signal.

 

Figure 6
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  		Fig. 1F —8-year-old boy with chronic constipation. Unenhanced sagittal T1 and sagittal T2 images give lateral view of lesion (arrow), which appears homogenous with low T1 and high T2 signal.

 

Figure 7
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  		Fig. 1G —8-year-old boy with chronic constipation. Contrast-enhanced T1 axial and sagittal images show peripheral enhancement with central fine enhancing septation (arrow).

 

Figure 8
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  		Fig. 1H —8-year-old boy with chronic constipation. Contrast-enhanced T1 axial and sagittal images show peripheral enhancement with central fine enhancing septation (arrow).

 

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