Objectives: Current guidelines recommend against abdominal radiograph (AXR) in the evaluation of pediatric recurrent or chronic abdominal pain (RAP). Based on our positive experience with AXR, we revisited this recommendation. Methods: A worldwide pediatric gastroenterology (PGI) physician survey was performed. Twenty pediatric RAP cases of the same physician were reviewed, where AXR was systematically employed. The PGI physician and two radiologists blindly scored stool burden in patients and 20 matched controls. Results: 17% of PGI specialists indicated using AXR in RAP patients without clinical constipation. Paradoxically, 81% reported recommending constipation therapy if AXR showed fecal retention. None of the 20 RAP patients met clinical criteria for constipation, however there was increased stool burden on 90% of AXRs. Constipation-predominant RAP remained the diagnosis in 90% after 6-month follow-up. Intra- and inter-observer agreement between blinded AXR interpretations were fair to perfect by Fleiss’s kappa analysis. The PGI physician called for fecal retention more commonly in cases than controls, significantly better than the radiologists. Conclusions: PGI-interpreted AXR during RAP evaluation may be valuable in certain settings and should be reexamined through prospective randomized trials.

Aim: To evaluate the results of surgical treatment of colovesical fistulas at a hospital in Southeastern Mexico. Introduction: Diverticular disease of the colon preferentially affects older adults, with 10%-25% developing complications that include colovesical fistula. The fact that there are few reports on its management in Mexico motivated us to carry out the present study. Material and methods: A retrospective and comparative study was conducted on patients seen at an advanced specialty hospital in Veracruz, that were divided into 2 groups: A) conventional surgery 86,36% and B) laparoscopic surgery 13,64%. Variables analyzed: Age, sex, risk factors, type of surgery, surgery duration, hospital stay, complications, and mortality.

Background: Duodenal lipoma is a rare benign tumour. Only 4% of all gastrointestinal lipomas are found in the duodenum causing a wide range of vague abdominal symptoms, intussusception or bleeding. Diagnosis is easily made during endoscopic ultrasound or computed tomography. There are no clear treatment guidelines or recommendations available.