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 4-year-old boy with prune belly syndrome who has chronic constipation. He is currently being managed with stool softeners. He is failing to empty his bowels, and soils daily. This patient has good potential for bowel control and he is mature enough to potty train as he has normal anatomy. Rectum appears dilated on contrast enema. There is no point of obstruction to suggest a stricture. This patient could be managed on laxatives or enemas. A future laxative trial can then be attempted when they are more mature and amenable to potty training. There is a significant psychological advantage to them once they "learn" what it is like to be clean from the mechanical emptying provided by the daily enema.
