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 4-month-old boy who presented to the clinic with difficulty stooling. This child has anal stenosis. There is a known association with a pre-sacral mass in this malformation and the child therefore needs a magnetic resonance imaging scan before the definitive repair. If a pre-sacral mass is present, this can be resected at the same time. If such a mass is detected it is likely a teratoma. A meningocele is also possible, and if the mass has any connection to the dura, neurosurgery will need to get involved. Full VACTERL screening would also be indicated in this case.
