Rectouterine Pouch/ Pouch of Douglas

1. POUCH OF DOUGLAS
Pubali Kalita
BPT

2. RectouterinePouchorPouchofDouglas
- Therectouterinepouch(pouchofDouglas,or
rectovaginalpouch)istheextensionoftheperitoneum
intothespacebetweentheposteriorwallofthe
uterusandtherectuminthehumanfemale.
- Itisthemostdependentpartoftheperitonealcavity
whenthebodyisintheuprightposition.
- Mostdependentpartofthepelviccavitywhenthe
bodyisinsupineposition.

4. -ThepouchofDouglasrepresentsthe
caudalextensionoftheperitonealcavity.Itis
therectovaginalpouchinthefemaleandthe
rectovesicalpouchinthemale.
- ThepouchofDouglasisagoodsitefor
peritonealdialysis,makingitinvaluablein
patientswithend-stagerenalfailure.Thetip
ofthedialysiscatheterisplacedintothe
deepestpointofthepouch.

5. Boundaries
Anteriorly,byuterusandtheposteriorfornixof
thevagina.
Posteriorly,byrectum.
Inferiorly,byrectovaginalfoldofperitonium.

6. Inwomen,(asdiscussedearlierinboundaries)the
rectouterinepouchisthedeepestpointofthe
peritonealcavity.Itisposteriortotheuterus,and
anteriortotherectum.Itsanteriorboundaryisformed
bytheposteriorfornixofthevagina.Thepouchonthe
othersideoftheuterusneartotheposteriorfornixisthe
vesicouterinepouch.
Afterpassingoverthefundusoftheuterus,the
peritoneumextendsinferiorlyalongtheentireposterior
aspectoftheuterus,reachingtheposteriorvaginalwall
beforereflectingsuperior-wardontotheanterioraspect
oftherectalampulla(i.e.theinferiorportionofthe
rectum).
Inmen,theregioncorrespondingtotherectouterine
pouchistherectovesicalpouch,whichliesbetweenthe
urinarybladderandrectum.

8.  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.