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 with Hirschsprung disease who underwent a pull-through as a baby, who is not doing well with potty training. She is 5 years old and continues to have problems with daily soiling. The exam reveled a damaged dentate line at the 4 o'clock to 8 o'clock position, which makes you conclude that there is a reduced likelihood that this child that will achieve future continence. Patients with Hirschsprung disease who are "not doing well" postoperatively need to be thoroughly assessed. This evaluation entails an EUA to check the dentate line, repeat rectal biopsy to check the pathology, and a contrast enema.
