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 female with rectovestibular fistula is receiving daily antegrade enemas via a cecostomy. She has a past medical history of VATER syndrome, Vesicoureteral reflux and Hemivaginas with vaginal septum. This child was initially managed with a change in her antegrade flush regimen to 500 mL normal saline and 20 mg glycerin. This regimen was successful and the flush time reduced to 45–60 minutes. The bisacodyl was likely provoking accidents given its stimulant activity. She was clean with this regimen, which increased her confidence, and she returned for a laxative trial.
