Full thickness external rectal prolapse, rectocele and enterocele

Case contributed by Vikas Shah
Diagnosis almost certain


Long history of difficult defecation, becoming worse. Feels lump protruding from back passage.

Patient Data

Age: 55 years
Gender: Female

The pelvic floor lies low at rest. As evacuation progresses, there is circumferential infolding of the full thickness of the upper and mid rectal walls into the low rectum, anal canal and finally beyond the anal verge. There is also a moderate-sized anterior rectocele with paste trapped within due to the intussusception. Small bowel loops are also seen to descend into the pelvic cavity, in keeping with an enterocele.

Case Discussion

This is a grade V intussusception - full thickness external rectal prolapse, with consequent trapping of paste within a moderate-sized anterior rectocele.

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