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 12-year-old girl with anorectal malformation and a rectovestibular fistula, which was repaired in the newborn period, who attends the clinic for further management. She has the following associated malformations: Esophageal atresia, Vesicoureteric reflux and Spinal hemivertebrae and scoliosis. When she was 8 years old, she was having fecal incontinence and daily soiling. A cecostomy was performed and antegrade enemas initiated. The postoperative anatomy of any child with a previous anorectal malformation repair needs to be checked for position of the anus and for evidence of a stricture or a rectal prolapse, all of which may warrant repair to provide the best possible anatomy to reach their continence potential.
