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 15-year-old girl with functional constipation. She developed problems with constipation at a young age, and this has been managed with high-dose stimulant laxatives and enemas, resulting in bowel movements only twice weekly, and she suffers from daytime soiling. The patient is failing to tolerate the stimulant laxatives and is experiencing severe abdominal cramps on a daily basis. It is important to look at the contrast enema for colonic dilation, but also to appreciate possible colonic redundancy if the patient is resistant to high-dose laxatives or experiences severe side effects. Colonic manometry is a useful guide to determine resection once one concludes that the patient has failed medical management. Collaboration with the GI motility team is key to helping these patients.
