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In part of its course, it is ridged by the underlying submucosa to form circular folds and the whole surface is covered by mucosal finger-like or leaf-like intestinal villi.
Rectal prolapse will often have a target-like appearance with circular folds of tissue circumferentially protruding from the anus--often up to 10-15 cm.
Stage IV hemorrhoidal disease is easily distinguished from rectal prolapse because prolapse features circular folds of tissue that come straight out toward the examiner.

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