ABSTRACT
This chapter explains the key principles in the management of complex pediatric colorectal diagnoses. It provides case-based presentations, radiographic images, operative images with Multiple Choice Questions to test knowledge. The chapter reviews a case of a male infant with an anorectal malformation. This case illustrates well the borderline between a posterior sagittal and a laparoscopic approach. The rectum is high but could be safely reached through a posterior sagittal incision alone, but the surgeon must recognize that it will be difficult and a long rectal dissection will be required. The urinary tract is at risk of injury. The rectum will be found high, above the level of coccyx. The rectum is very dilated and likely to make the laparoscopic approach difficult, but this would be a reasonable approach.
