Pediatric and Congenital Colorectal Diseases in the Adult Patient

David M. Gourlay, MD, FACS, FAAP

In this edition, we provide the most current information for a wide breadth of colorectal diseases that affect pediatric patients. The authors impressively provide a concise review of an enormous amount of information for the non-pediatric surgeon who may be faced with either managing a pediatric patient de novo, an adult patient who presents with a previously undiagnosed congenital anomaly, or an adult patient who presents with a history of treatment for a congenital anomaly of the colon and rectum.

This issue discusses colorectal diseases common to both pediatric and adult patients. While many of these diseases occur in both pediatric and adult patients, their presentation and care is often distinctly different. The authors of the chapters on Anorectal Complaints, Ulcerative Colitis, Crohn's Disease, Pediatric Polyposis Syndromes, Rectal Prolapse, and Idiopathic Constipation provide excellent content on how pediatric patients present as well as the most recent evidence based management of the disease.

Other colorectal diseases as discussed in the chapters on Anorectal Malformations, Hirschsprung Disease, Congenital Pseudo-Obstruction, Meconium Ileus, and Enteric Duplications present almost exclusively in the childhood. Given the regionalization of specialized pediatric care, many adult surgeons may be asked to provide care for pediatric patients who present with these diseases. It is therefore critical that the adult surgeon understands the common colorectal diseases that affect the pediatric patient as well as their treatment. The authors of these chapters have provided an exceptional review of each of these diseases.

Almost all patients with these diseases of the colon and rectum will survive well into adulthood. While most of these patients will have a reasonable functional outcome, many will require ongoing surgeon-directed care into adulthood for these conditions or their complications. We tried to highlight the long-term outcomes and complications that may occur with each disease process.

I am grateful to each of these authors, each are experts in the field, who volunteered to assist in producing this edition. I am indebted to each of them for their time spent preparing their respective chapters. I also want to thank Dr. Scott Steele for the opportunity to be the “Guest Editor” for this edition. His tireless drive is inspirational.