Where is pouch of douglas

The cul-de-sac , also known as the pouch of Douglas or rectouterine pouch , is an extension of the postero-inferior reflection of the peritoneal fold between the uterus anteriorly and rectum posteriorly.

It is the most inferior aspect of the peritoneal cavity and therefore the first location where free fluid accumulates. Presence of fluid within the cul-de-sac is a common finding, and the underlying cause can be thought of as either physiological or pathological. Physiological pelvic intraperitoneal fluid in women may be due to:.

Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Become a Gold Supporter and see no ads. If the fluid surrounded the uterus and was found anterior and superior to the uterus as well, the volume of the uterus was calculated and subtracted from the measurement of the fluid pocket.

The study determined that the measurements of fluid volumes correlated with the amount of fluid instilled in the patient during the study and were reproducible. On the other hand, the absence of fluid in the pouch of Douglas may also have clinical significance. For example, in a patient with endometriosis, an obliterated cul-de-sac secondary to agglutination of the peritoneal surfaces from scarring caused by infiltrating endometriosis will prevent fluid from pooling here.

The pouch of Douglas should always be evaluated at the time of a transvaginal ultrasound, as the findings are often helpful in supporting a pelvic pain diagnosis.

Because fluid from the pouch of Douglas protects the body from contamination, checking it on transvaginal ultrasound is vital. Why make her wait for a diagnosis? Use ultrasound to detect adenomyosis.

The information on this web page is intended for healthcare professionals only. Follow GE Healthcare for the latest updates. Stay informed. Lisbet Hanson March 25, Transvaginal ultrasound image of small amount of fluid in cul-de-sac arrow What Is the Pouch of Douglas? What to Look for in the Pouch of Douglas Studies published in in Radiology and in in the Journal of Ultrasound in Medicine demonstrated that echogenic masses and cul-de-sac fluid on transvaginal ultrasound are highly predictive of the finding of clotted blood and hemoperitoneum.

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The flesh is soft and bloody. Provenance: Commissioned; not externally peer reviewed. Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion. You will be notified by email within five working days should your response be accepted. Basic Search Advanced search search. Use the Advanced search for more specific terms.

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Narrative reviews. Ethics and law. Medical education. Volume Issue Med J Aust ; 11 : Topics History and humanities. View this article on Wiley Online Library.