Mnemonic

Peritoneal Pouches

A memory aid for the dependent peritoneal pouches of the pelvis.

Expansion

Rectovesical pouch in the male; vesicouterine and rectouterine pouches in the female

Expansion

Male

  • Rectovesical pouch - between the rectum and the bladder

Female

  • Vesicouterine pouch - between the bladder and the uterus
  • Rectouterine pouch (of Douglas) - between the uterus and the rectum; the deeper of the two

These are the most dependent parts of the peritoneal cavity when upright, so pus, blood and malignant deposits gravitate here.

Clinical consequences:

  • A pelvic abscess presents with diarrhoea, mucus and tenesmus from rectal irritation, and is palpable on rectal or vaginal examination
  • Blood from a ruptured ectopic pregnancy collects here, causing cervical excitation
  • Peritoneal metastases here form a palpable shelf on rectal examination