Full thickness rectoanal intussusception
Difficult defaecation. Feeling of pressure in back passage.
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The pelvic floor lies low at rest. A vaginal ring pessary is present. As evacuation progresses, there is circumferential infolding of the full thickness of the upper and mid rectum into the low rectum, but not beyond the anal margin.
These are findings of a grade IV intussusception - the full thickness of the rectum prolapsing down into the anal canal but not beyond the anal verge.