Presentation
Pelvic pain with difficult defecation.
Patient Data
Age: 40 years
Gender: Female
From the case:
Anterior rectocele
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Anterior bulging of the rectal wall into the posterior vaginal wall 33 mm beyond the anorectal wall during dynamic sequences (defecation) in keeping with a moderate anterior rectocele.
Moderate inferior descent of anorectal junction 35 mm below the pubococcygeal line during the defecation phase
the bladder floor and uterine cervix remain above the pubococcygeal line during the defecation phase.
Retroverted retroflexed uterus with normal thickness of the junctional zone.
Normal appearance of both ovaries. Mild effusion in Douglas pouch.
From the case:
Anterior rectocele
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Annotated images:
- yellow line: pubococcygeal line (PCL line)
- red line; perpendicular line from the PCL to the anorectal junction
- green line: anterior rectocele
Case Discussion
MRI proctogram of a moderate anterior rectocele with moderate anorectal descent.