Solution: Defecography is a mechanism by which functional issues with defecation can be more fully evaluated. It involves the use of a thick barium paste to simulate stool, as well as small bowel contrast, vaginal contrast (when appropriate), and sometimes bladder contrast. The most common abnormalities are issue related to pelvic floor laxity and include, rectal prolapse, cytoceles, vaginal prolapse, intussusception, rectoceles, and as in this case enteroceles. Enteroceles occur almost exclusively in women, but can be seen in male patients after prostatectomy. This patient was a male without history of prostatectomy, so this diagnosis is very unusual and must be related to a developmental issue related to the pelvic floor. The small bowel can be seen to descend below the normal level of the pelvic floor during evacuation and places mass effect on the adjacent rectum limiting the ability to empty the colon and rectal vault.