Obstructive constipation

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Suffers from anal pain and a sensation of perineal pressure.

Patient Data

Age: 40 years
Gender: Male

Evacuation proctography

Fluoroscopy

Normal anatomy of rectum and anus at rest.
On anal contraction, good elevation of the rectum and anus.

On evacuation:

  • rapid and complete rectal evacuation
  • descent of 4 cm of the recto-anal junction
  • intra-anal intussusception of the rectum and prolapse of a small bowel loop, which halts at the rectosigmoid junction

Case Discussion

Descending perineum, intra-anal intussusception, and enterocele.

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