Stay Current In Pediatric Surgery

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of managing megarectosigmoid in a 13-year-old patient with a history of cloaca. They explore the intricacies of diagnosis, anatomy, and long-term management for a child struggling with soiling despite a well-positioned rectum and no anatomical stricture.Key Highlights:Case Discussion: A deep dive into a patient with severe rectal dilation despite a perineal repair and normal bladder function.Diagnostic Strategy: The role of MRI, EUA, contrast enema, and sacral assessment to understand anatomy and guide treatment.Treatment Options: From Malone procedures to tapering and resection—what’s the right next step?Surgical Pearls: When to preserve the rectum and when to consider redoing the entire repair.This episode is packed with expert commentary, clinical pearls, and plenty of humor (including a colorectal-themed joke from a young patient).