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Findings: Defacography was performed which demonstrated an anterior outpouching of the wall of the rectum consistent with a rectocele.
Diagnosis: Rectocele.
Discussion: A rectocele can be described as a bulge in the anterior wall of the rectum, as the patient strains downward. Among the most common symptoms associated with a rectocele are the feeling of incomplete bowel movement and discomfort after evacuation. The symptoms of incomplete emptying may be relieved by pressure to the vagina or perineum which facilitates emptying. The rectocele is the result of inadequate support or laxity of endopelvic fascia above the anal canal. It has variously been considered secondary to obstetric injury or repeated straining due to a pre-existing disorder of defecation. Symptomatic rectoceles are usually large and demonstrate barium trapping as in the case above. They are also frequently associated with prolapse or intussusception.
References:
Karasick S, Karasick D, Karasic SR. Functional Disorders of the Anus >br>
and Rectum: Findings on Defecography.
Kelvin FM, Maglinte DDT, Hornback JA, Benson JT. Pelvic Prolapse: Assessment
With Evacuation Proctography (Defecography). Radiology 184:547-551, 1992.
Ikenberry S, Lappas JC, Hana MP, Rex DK. Defecography in Healthy Subjects:
Comparison of Three Contrast Media. Radiology 201:233-238, 1996.
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