The major principle of operative therapy for Hirschsprung's disease is to bring ganglionated bowel to within 1 cm of the dentate line.• The ideal surgical treatment of a duplication depends on length and location of duplication, age of child, and relationship to surrounding structures with complete excision being the goal, though not always possible. • Constipation and fecal incontinence need a full history and physical examination but are managed often successfully by medical management. • Anorectal malformations often occur with other congenital defects and a mainstay for surgery is an ano rectoplasty.