Recto-uterine pouch

Recto-uterine pouch

Sagittal section of the lower part of a female trunk, right segment. (Excavatio recto-uterina labeled at bottom right.)

Median sagittal section of female pelvis. (Rectouterine excavation labeled at center left.)
Details
Identifiers
Latin excavatio rectouterina, cavum douglassi, fossa douglasi
MeSH A01.047.025.600.225
TA A10.1.02.512
FMA 14728

Anatomical terminology

The recto-uterine pouch, also known by various other names, is the extension of the peritoneal cavity between the rectum and the posterior wall of the uterus in the female human body.

Structure and physiology

In women it is the deepest point of the peritoneal cavity, posterior to (behind) the uterus and anterior to (in front of) the rectum. (The pouch on the other side of the uterus is the vesico-uterine pouch.) It is near the posterior fornix of the vagina.

It is normal to have approximately 1 to 3 ml (or mL) in the recto-uterine pouch throughout the menstrual cycle.[1] After ovulation there is between 4 and 5 ml of fluid in the recto-uterine pouch.[1]

In men, the region corresponding to the recto-uterine pouch is the recto-vesical pouch, which lies between the urinary bladder and rectum. (There is no equivalent to the vesico-uterine pouch).

Pathology

The recto-uterine pouch, being the lowest part of the peritoneal cavity in a woman at supine position, is a common site for the spread of pathology such as ascites, tumour, endometriosis, pus, etc.

Naming and etymology

The recto-uterine (or rectouterine) pouch is also called the recto-uterine (or rectouterine) excavation, utero-rectal (or uterorectal) pouch, recto-vaginal (or rectovaginal) pouch, pouch of Douglas (after anatomist James Douglas, 1675–1742), Douglas pouch,[2] Douglas cavity,[2] Douglas space,[2] Douglas cul-de-sac,[2] Ehrhardt–Cole recess, Ehrhardt–Cole cul-de-sac, cavum Douglasi, or excavatio rectouterina. The combining forms reflect the rectum (recto-, -rectal) and uterus (utero-, -uterine).

The Douglas fold (rectouterine plica), Douglas line, and Douglas septum are likewise named after the same James Douglas.

Culdotomy

A culdotomy or posterior colpotomy is an incision or needle puncture of this "cul-de-sac" pouch by way of the vagina.

Clinical significance

As it is the furthest point of the abdominopelvic cavity in women, it is a site where infection and fluids typically collect.[3]

The recto-uterine pouch is used in the treatment of end-stage renal failure in patients who are treated by peritoneal dialysis. The tip of the dialysis catheter is placed into the deepest point of the pouch.

Additional images

See also

References

  1. 1 2 Severi FM, Bocchi C, Vannuccini S, Petraglia F (2012). "Ovary and ultrasound: from physiology to disease" (PDF). Archives of Perinatal Medicine. 18 (1): 7–19.
  2. 1 2 3 4 synd/2937 at Who Named It?
  3. ↑ Drake, RL (2010). Gray's Anatomy for Students. Churchill Livingstone. p. 460.

Further reading

This article is issued from Wikipedia - version of the 11/18/2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.