Rectouterine Pouch.pptx

Rectouterine Pouch/ Pouch of Douglas

1. POUCH OF DOUGLAS Pubali Kalita BPT

2. Rectouterine Pouch or Pouch of Douglas - The rectouterine pouch ( pouch of Douglas, or rectovaginal pouch) is the extension of the peritoneum into the space between the posterior wall of the uterus and the rectum in the human female . - It is the most dependent part of the peritoneal cavity when the body is in the upright position . - Most dependent part of the pelvic cavity when the body is in supine position .

3. - The pouch of Douglas represents the caudal extension of the peritoneal cavity. It is the rectovaginal pouch in the female and the rectovesical pouch in the male . - The pouch of Douglas is a good site for peritoneal dialysis, making it invaluable in patients with end-stage renal failure. The tip of the dialysis catheter is placed into the deepest point of the pouch .

4. Boundaries Anteriorly , by uterus and the posterior fornix of the vagina . Posteriorly , by rectum . Inferiorly , by rectovaginal fold of peritonium .

5. In women, (as discussed earlier in boundaries) the rectouterine pouch is the deepest point of the peritoneal cavity. It is posterior to the uterus, and anterior to the rectum. Its anterior boundary is formed by the posterior fornix of the vagina. The pouch on the other side of the uterus near to the posterior fornix is the vesicouterine pouch. After passing over the fundus of the uterus, the peritoneum extends inferiorly along the entire posterior aspect of the uterus, reaching the posterior vaginal wall before reflecting superior-ward onto the anterior aspect of the rectal ampulla (i.e. the inferior portion of the rectum).

In men, the region corresponding to the rectouterine pouch is the rectovesical pouch, which lies between the urinary bladder and rectum.

6. 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.