For SOME YEARS past, textbooks of radiology and medicine have included brief mention of an entity known as “rectal dyschezia.“ Usually the subject is dismissed very briefly, and comments on the etiology are vague. Illustrations accompanying the discussions often picture a dilated rectum, the dilatation sometimes encroaching upon the rectosigmoid. The condition is set down as due to decreased irritability of the rectum and to diminution of the impulse to defecate, with a consequent accumulation of feces in the rectal ampulla. Several features of such a case recently coming under our observation prompted us to investigate the subject of “dyschezia” more thoroughly, and the ineptness-or we might say obsolescence-of the term was impressed upon us as we probed for diagnostic criteria or illuminating notes on etiology. Case Report C. E., housewife, twenty-seven years of age, had experienced difficulty in emptying her bowels since childhood. Fecal accumulations at that time had given her so much distress that her father had repeatedly cleaned out the scybalous masses digitally. Later she came to depend upon enemas, but found them increasingly inefficient. She could introduce the enema solution, fill the colon, and evacuate the solution, but the increasing abdominal mass would be unaffected. The patient first came under observation with an acute abdominal attack, diagnosed as appendicitis. At operation the pelvis was found filled by a huge, dilated segment of bowel. Following the operation, a fecal accumulation was removed by a series of enemas. The patient was next seen for pregnancy, and a fecal mass had to be dealt with as before. At the time of delivery there was a reaccumulation of feces, despite which a normal delivery was effected. Following delivery, colonic flushings were resumed by the patient but she later sought advice because of the return of the pelvic mass. A barium enema was given, and the accompanying illustrations reveal the picture which was presented. At first it seemed impossible to introduce the barium; then a faint trickle of the suspension was seen surrounding a mass which completely filled the rectal ampulla. When the colon had been filled, barium entirely obscured the underlying mass. The roentgen diagnosis was a huge scybalum filling a greatly dilated rectum. This was confirmed clinically when, by a series of enemas, the fecal accumulation was gradually broken up and evacuated, with disappearance of the mass. This patient had no evidence of any rectal stricture or atresia, and the fact that during her childhood her father had been able manually to remove fecal impactions would seem evidence that she had no atresia then. A review of the literature on “congenital idiopathic dilatation of the colon” reveals an interesting change in trend of thought so far as etiology is concerned.