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 6-year-old female with H-type rectovaginal fistula. Rectovaginal fistulae can present as labial abscesses or perirectal abscesses and the surgeon should ask about previous episodes of perineal sepsis. The child may also have a history of constipation and recurrent urinary tract infection. Rectovaginal fistulae are known to be associated with rectal stenosis and a history of constipation, and this should be examined for. Patients with a H-type rectovaginal fistulae may have rectal stenosis, and this is known to be associated with a pre-sacral mass; therefore, the child should undergo a spinal magnetic resonance imaging scan. All patients with a perianal or labial abscess should have a rectal examination in order to rule out anal stenosis.
