Rectal mucosa protrudes no more than 1 inch below anus (shown on defecography)
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External (complete) prolapse (procidentia)
All layers of rectum protrude through anus
Diagnosis made on physical exam or defecography
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Rectosigmoid (internal) intussusception
Proximal rectal ± sigmoid mucosa telescopes into distal rectum; rarely through anus
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Often “pinches off” base of anterior rectocele
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Contributes to sensation of incomplete evacuation
Diagnosed on defecography or MR
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Rectal ulcer syndrome
Traumatic or ischemic ulceration of rectal mucosa associated with disordered evacuation
Diagnosed on barium enema or sigmoidoscopy
95% of affected patients have internal intussusception
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