Rectouterine pouch

Changed by Stephanie BM Tan, 24 Dec 2016

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The rectouterine pouch, 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.

Gross anatomy

Boundaries
  • anteriorly: uterus, posterior fornix of the vagina
  • posteriorly: rectum
  • inferiorly: peritoneal rectovaginal fold

Related pathology

Being a most dependent and lower area of the peritoneal cavity of females in the supine position,fluids (e.g. abscess, infection, ascites, haemoperitoneum, 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 Dr James Douglas (1675–1742).

  • -<p>The <strong>rectouterine pouch</strong>, also known as the <strong>rectovaginal pouch</strong>, <strong>cul-de-sac</strong> or <strong>pouch of Douglas</strong>, is an extension of peritoneum between the posterior wall of <a href="/articles/uterus">uterus</a> and the <a href="/articles/rectum">rectum</a> in females. It is the most dependent part of the <a href="/articles/peritoneum">peritoneal cavity</a> and is analogous to the <a href="/articles/rectovesical-pouch">rectovesical pouch</a> in males. </p><h4>Gross anatomy</h4><h5>Boundaries</h5><ul>
  • +<p>The <strong>rectouterine pouch</strong>, also known as the <strong>rectovaginal pouch</strong>, <strong>cul-de-sac</strong> or <strong>pouch of Douglas</strong>, is an extension of peritoneum between the posterior wall of <a href="/articles/uterus">uterus</a> and the <a href="/articles/rectum">rectum</a> in females. It is the most dependent part of the <a href="/articles/peritoneum">peritoneal cavity</a> and is analogous to the <a href="/articles/rectovesical-pouch">rectovesical pouch</a> in males.</p><h4>Gross anatomy</h4><h5>Boundaries</h5><ul>
  • -</ul><h4>Related pathology</h4><p>Being a most dependent and lower area of the peritoneal cavity of females in the supine position, fluids (e.g. abscess, infection, <a href="/articles/ascites">ascites</a>, <a href="/articles/haemoperitoneum">haemoperitoneum</a>, and even <a title="Peritoneal metastases" href="/articles/peritoneal-metastases">intraperitoneal drop metastases</a>) preferentially collects here. </p><p>A small amount of homogeneous and low-attenuated fluid in the rectouterine pouch is normally seen in child-bearing age women. </p><p>The pouch is useful in <a title="End-stage renal failure" href="/articles/end-stage-kidney-disease">end-stage renal failure</a> patients, where it is a preferred place for peritoneal dialysis.</p><h4>History and etymology</h4><p>It is named after the Scottish anatomist <strong>Dr James Douglas</strong> (1675–1742).</p>
  • +</ul><h4>Related pathology</h4><p>Being a most dependent and lower area of the peritoneal cavity of females in the supine position, fluids (e.g. abscess, infection, <a href="/articles/ascites">ascites</a>, <a href="/articles/haemoperitoneum">haemoperitoneum</a>, and even <a href="/articles/peritoneal-metastases">intraperitoneal drop metastases</a>) preferentially collects here.</p><p>A small amount of homogeneous and low-attenuated fluid in the rectouterine pouch is normally seen in child-bearing age women.</p><p>The pouch is useful in <a href="/articles/end-stage-kidney-disease">end-stage renal failure</a> 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. </p><h4>History and etymology</h4><p>It is named after the Scottish anatomist <strong>Dr James Douglas</strong> (1675–1742).</p>

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