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 patient who was diagnosed with Hirschsprung disease when he was a few days old and underwent a Soave endorectal pull-through with laparoscopy as a newborn infant. Since the time of the pull-through, he has had many episodes of enterocolitis. He presents with distension and fever. The radiograph demonstrates significant colonic dilatation. He is now 2 years of age. This child requires colonic decompression with rectal irrigations and antibiotics, with adequate intravenous fluid replacement. There is narrowing of the bowel distally with colonic distention more proximally, which is suggestive of a stricture. This child needs a redo of his pull-through to manage the stricture.
