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Culdocentesis is a medical procedure involving the extraction of fluid from the rectouterine pouch (pouch of Douglas) [1] posterior to the vagina through a needle. It can be one diagnostic technique used in identifying pelvic inflammatory disease (in which case purulent fluid will be extracted) and ruptured ectopic pregnancies that cause hemoperitoneum.
The rectouterine (or recto-uterine) pouch is also called the rectouterine excavation, uterorectal pouch, rectovaginal pouch, pouch of Douglas (after anatomist James Douglas, 1675–1742), Douglas pouch, [6] Douglas cavity, [6] Douglas space, [6] Douglas cul-de-sac, [6] Ehrhardt–Cole recess, Ehrhardt–Cole cul-de-sac, cavum Douglasi, or excavatio rectouterina.
When a man is upright or supine, the rectovesical pouch is the lowest part of his peritoneal cavity. [3] Because of this, peritoneal fluid and other fluids that enter the peritoneal cavity, including ascites, blood and pus, tend to collect in this pouch.
Blumer's shelf, or the rectal shelf, is a finding palpable (felt) in rectal or vaginal examination that indicates that a tumor has metastasized to the pouch of Douglas.. It is usually a site of metastasis of cancers of the lung, pancreas and stomach, [1] due to metastatic tumor cells gravitating from an abdominal cancer and growing in the rectovesical [2] or rectouterine pouch.
A cul-de-sac hernia (also termed a peritoneocele) is a herniation of peritoneal folds into the rectovaginal septum (in females), [2] or the rectovesical septum (in males). The herniated structure is the recto-uterine pouch (pouch of Douglas) in females, [2] or the rectovesical pouch in males.
An inflated bulb of the catheter prevents leakage of fluid outside uterine cavity. By visualizing the flow of saline along the tube and observing it as a shower at fimbrial end, tubal patency can be tested. Presence of free fluid in pouch of Douglas also confirms tubal patency.
Next, thrust in an inward and upward motion on the diaphragm. This will force air out of the lungs and remove the blockage. Repeat these abdominal thrusts up to five times, the doctor advised.
Culdoscopy is an endoscopic procedure performed to examine the rectouterine pouch and pelvic viscera by the introduction of a culdoscope through the posterior vaginal wall. [1] The word culdoscopy (and culdoscope) is derived from the term cul-de-sac, which means literally in French "bottom of a sac", and refers to the rectouterine pouch (or called the pouch of Douglas).