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 11-year-old girl with a history of chronic (functional) constipation. She has previously been managed on high-dose laxatives, which failed to resolve her symptoms. A cecostomy was placed and attempts were made to manage her with cecostomy flushes: Saline 500 mL and glycerin 20 mL. The antegrade cecostomy flushes also failed to empty the colon and she went on to have colonic motility studies. The child was noted to be failing to thrive. Her weight was plotted below the 3rd centile. The decision was made to manage this child with an ileostomy, to give the colon a period of time diverted. In the 4-month period post-ileostomy creation, she gained over 10 kg in weight.
