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Fig. 5B —Anal sphincter defects shown in four patients. Axial transvaginal image obtained with probe in 22-year-old woman with fecal incontinence after severe previous injury from boat propeller shows unusual disruption of anal sphincters. There are two defects: one anteriorly in external anal sphincter, showing hypoechoic defect from 12- to 2-o'clock positions, and second full-thickness defect of internal anal sphincter and external anal sphincter from about 6- to 9-o'clock positions. These multifocal defects suggest difficulty for surgical repair.