Query rectal prolapse.
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Preliminary images show orthopaedic metalware in the right femur.
The fluoroscopic images taken upon bearing up and bearing down demonstrate:
- appropriate elevation of the anorectal angle on bearing up
- appropriate descent of the pelvic floor and anorectal junction on bearing down
The fluoroscopic images taken upon defaecating demonstrate:
- initially, a small protrusion of the anterior rectal wall (anterior rectocoele)
- the rectum is then seen to descend and prolapse outside the anus
- no associated vaginal prolapse
The rectum emptied well with only a small amount of contrast remaining in the rectum on post evacuation images.
This case demonstrates an external rectal prolapse on fluoroscopy. This may be associated with vaginal prolapse, but not in this case.
Case thanks to Dr Alex Jarema.