Full thickness external rectal prolapse and enterocele
Lump coming out from back passage when opening bowels
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The pelvic floor has a normal position at rest. As evacuation commences, there is rapid expulsion of the rectal paste with complete eversion of the rectum out through the anal verge. Opacified small bowel loops then descend to fill the space in the pelvis vacated by the prolapsed rectum.
This is a grade V full thickness external rectal prolapse with an enterocele. In most cases, these do not require imaging as they are visible in the clinic to the surgeon, but occasionally they cannot be reproduced in the clinic so radiologic confirmation is requested.