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 3-year-old male child with a past medical history of an anorectal malformation. He has a scar on the abdomen from a previous colostomy that has been reversed. On examination of the perineum, he has evidence of a previous rectal repair. He is adopted and there is no past medical or surgical history available to you when you take over the medical care. If a male child has evidence of a previous colostomy, then it is likely that the child had a rectourethral fistula (rectobulbar or rectoprostatic) or a bladder neck fistula. From the magnetic resonance imaging scan of the pelvis, it appears that the remnant of the original fistula (ROOF) is at the rectoprostatic level in this case.
