Rectouterine pouch
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At the time the article was created Balaji Vasu had no recorded disclosures.
View Balaji Vasu's current disclosuresAt the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures- Pouch of Douglas
- Rectovaginal pouch
- Recto-uterine pouch
- Ehrhardt-Cole recess
- Douglasi cavum
- Cavum Douglasi
- Recto-uterine extracavation
- Utero-rectal pouch
- Recto-vaginal pouch
- Douglas cavity
- Douglas space
- Douglas cul-de-sac
- Posterior cul-de-sac
- Ehrhardt–Cole cul-de-sac
- Excavatio rectouterina
- Uterorectal pouch
- Douglas pouch
- Rectouterine extracavation
- Recto-uterine pouch
- Cul-de-sac
The rectouterine pouch (TA: excavatio rectouterina 3), also known as the rectovaginal pouch, cul-de-sac or pouch of Douglas, is an extension of peritoneum between the posterior wall of uterus and the rectum in females. It is the most dependent part of the peritoneal cavity and is analogous to the rectovesical pouch in males.
On this page:
Gross anatomy
Boundaries
anteriorly: uterus, posterior fornix of the vagina
posteriorly: rectum
inferiorly: peritoneal rectovaginal fold
Related pathology
Being the most dependent and lower area of the peritoneal cavity of females in the supine position, fluids (e.g. abscess, infection, ascites, hemoperitoneum, and even intraperitoneal drop metastases) preferentially collects here.
A small amount of homogeneous and low-attenuated fluid in the rectouterine pouch is normally seen in child-bearing age women.
The pouch is useful in end-stage renal failure patients, where it is a preferred place for peritoneal dialysis. The distal end of the Tenckhoff catheter is placed in the pouch, and occasionally sutured to the bladder to avoid migration.
History and etymology
It is named after the Scottish anatomist James Douglas (1675–1742) 2.
References
- 1. Brant WE, Helms CA. Fundamentals of Diagnostic Radiology. Lippincott Williams & Wilkins. (2007) ISBN:0781761352. Read it at Google Books - Find it at Amazon
- 2. William Alexander Newman Dorland. Dorland's Illustrated Medical Dictionary. (2018) ISBN: 9781416023647
- 3. FIPAT. Terminologia Anatomica. 2nd Ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, 2019. https://fipat.library.dal.ca/TA2/
Incoming Links
- Medical abbreviations and acronyms (P)
- Endometriosis
- Pelvic inflammatory disease
- Differential diagnosis of free fluid in cul de sac (pouch of Douglas)
- Peritoneal spaces
- Sliding sign
- Abdominal ectopic pregnancy
- Fallopian tube
- Point-of-care ultrasound (curriculum)
- Kissing ovaries sign
- Ovary
- Physiological pelvic intraperitoneal fluid
- Vagina
- Pelvic peritoneal space
- Uterosacral ligament
- Uterus
- Pyometrium
- Focused Assessment with Sonography for Trauma (FAST) scan
- Endosalpingiosis
- Ectopic pregnancy
- Endometriosis - kissing ovaries sign
- Intracavitary fibroid
- Tip appendicitis
- Bilateral ovarian endometriomas with subperitoneal involvement
- Endometrioma
- Tubo-ovarian torsion
- Actively leaking ectopic pregnancy
- Ovarian serous cystadenoma
- Deep infiltrating endometriosis - peritoneal
- Ovarian endometriomas (kissing ovaries sign)
- Pyosalpinx
- Heterotopic pregnancy
- Rectal cancer with uterine invasion
- Mesentery (sagittal)
- Blood in uterovesical and rectovesical pouch in trauma patient
- Normal pelvic ultrasound - transvaginal
- Rectovaginal fistula
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