WOFAPS 2025 8th World Congress of Pediatric Surgery

Judith Lindert, Naemi Kurzweil, Daniel Erkel, Stefanie Märzheuser

Department of Paediatric Surgery, University Rostock

Assessment of fecal load is an essential component of long-term follow-up in children with colorectal conditions. While the use of ultrasound in this context is under debate, it offers a potential non-radiative alternative to imaging techniques such as X-ray. This study evaluates the interrater reliability of transabdominalrectal ultrasound measurements in pediatric patients with Hirschsprung’s disease, Anorectal Malformation, Chronic Constipation, and healthy controls.

This investigation is a substudy of the ReKiSo study. Between October 2024 and June 2025, a total of 220 ultrasound measurements were independently obtained by two examiners. A Toshiba Aplio 300 ultrasound machine equipped with a curved array probe was used. The transducer was positioned just proximal to the pubic symphysis and angled 15 degrees caudally in the transverse plane.

Measurements were performed independently by two raters: a pediatric surgery consultant and a medical student. Interrater reliability was assessed using the Intraclass Correlation Coefficient (ICC), which yielded a value of 0.954. This reflects excellent agreement between observers and supports the use of transrectal ultrasound as a reliable diagnostic tool in pediatric colorectal assessment. Despite concerns about user dependency, these findings suggest that with appropriate training, ultrasound may serve as a consistent and non-invasive alternative for evaluating fecal load.