Full thickness rectoanal intussusception

Case contributed by Vikas Shah
Diagnosis almost certain


Feeling of lump protruding into anal canal, ? prolapse

Patient Data

Age: 35 years
Gender: Female

MRI proctogram


Structural findings:
Normal structure appearances of the pelvic viscera.  Normal and symmetric appearances of the levator musculature.

Dynamic findings:
Measurements obtained at maximal straining using the PCL system are as follows:
Bladder neck: 37 mm below line (mild cystocele)
Uterine cervix: 10 mm below line (normal)
Anorectal junction: 52 mm below line (mild anorectal junction descent)

Rectocele: none

At the onset of evacuation, there is global pelvic floor descent, with rapid emptying of the ultrasound gel.  Initially, there is mucosal thickening of the mid rectum with intussusception into the anal canal, with a small full-thickness rectal prolapse identified at the end of the study, but not protruding beyond the anal margin. There is no enterocele.

In summary:
No structural abnormality.
Global pelvic floor descent during evacuation.
Full-thickness rectal prolapse but not beyond the anal margin (grade 4).

Case Discussion

The study confirms the cause of the symptoms as full thickness rectoanal intussusception.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.