An Unexpected Finding on Digital Rectal Examination

An 85-year-old frail female presented for ileocolonoscopy under conscious sedation for workup of symptomatic constipation. Digital rectal examination (DRE) before scope insertion revealed a palpable ring structure with a smooth surface. In accordance, endoscopic visualization of the rectum revealed with an excavating doughnut-shaped impression at the anterior rectal wall with normal overlying mucosa. (Figure 1) While ileocolonoscopy proved otherwise normal, dedicated medical history and additional imaging studies confirmed the presence of a partly dislodged intravaginal pessary.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research