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 presents a case study of a 2-year-old female born with an anorectal malformation. Neurosurgical assessment showed lower extremity weakness and the decision was made to operate for spinal cord detethering. When the original surgery and the type of anorectal malformation is unknown, the child requires a thorough workup, including EUA and assessment of the spine, sacrum, and renal system. In this child a number of important factors were found: Misplaced anus, Tethered spinal cord requiring release, Grade V reflux with poor-functioning left kidney and Ectopic ureter. Ultimately a redo PSARP was performed to locate the anus within the sphincter mechanism.
