Reliability of Barr, Leech, and Blethyn Scores in Determining Fecal Impaction in Children.


eMediNexus    10 April 2018

The aim of a study published in Arquivos de Gastroenterologia was to evaluate Barr, Blethyn, and Leech scores in the assessment of fecal load in plain radiograph. This case control study enrolled children, 2-14 years of age, with abdominal pain who visited Abuzar Childrens Hospital of Ahvaz University of Medical Sciences. Children with history of previous abdominal surgery or any systemic illness including sickle cell anemia were excluded. Among the children included, 102 subjects with constipation formed case group, while those without constipation constituted the control group. Here, the Rome III criteria was used for defining constipation. It was observed that the Leech score (mean ±SD) was 11.05±2.177 and 5.67±3.228 for case and control groups, respectively. While, the Barr score (mean ±SD) was 14.86±3.54 and 7.16±5.59 for case and control groups, respectively. Furthermore, the Blethyn (mean ±SD) score was 1.97±0.667 and 1.04±0.900 for case and control groups, respectively. Sensitivity and specificity of the Barr score was 83% and 79%, respectively, while sensitivity and specificity of the Leech score was 92% and 80%, respectively. Whereas, sensitivity and specificity of the Blethyn score was 79% and 92% respectively. The findings indicated that Barr, Blethyn and Leech scores were significantly higher in children with abdominal pain and constipation unlike in children with abdominal pain without constipation. Hence, it was stated that the sensitivity of the Leech score was more than those of Barr and the Blethyn scoring systems. Meanwhile, the specificity of Blethyn score was more than Barr and Leech scores.

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