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 an 8-year-old boy who has had a previous posterior sagittal anorectoplasty for repair of a rectoprostatic fistula. This child's anus is posteriorly mislocated and is lying outside of the sphincter complex. He will be unable to squeeze the anus closed as it is lying outside the muscle complex, which is one of the major contributing factors to his fecal incontinence. His spine needs to be assessed for associated tethered cord, which could also affect his continence potential. His original malformation was a rectoprostatic fistula and therefore his potential for continence is less than that of a "lower" malformation, such as a bulbar or perineal fistula. At this age, he would benefit from a reliable method of bowel management.
