Rectovaginal examination also suggested fullness in the
rectouterine pouch.
The medial pararectal space is called Okabayashi's space and it is between the ureter and the rectouterine ligament, which is developed after opening the posterior leaf of the broad ligament (Figure 20).
Access to this area can be maintained by cutting the rectouterine peritoneal structure between the insertions of the uterosacral ligament, which lie bilaterally.
On bimanual exam, uterus was retroverted and part of IUD was palpable in
rectouterine pouch.
After retraction of coils of intestine, it is seen present between the urinary bladder in front and rectum behind separated by vesicouterine pouch and
rectouterine pouch respectively.
A suprapubic catheter and two surgical drains (one in the hepatorenal fossa and the other in the
rectouterine pouch) were used.
The largest mass was 7.9 x 7.7 x 8.7 cm in the
rectouterine pouch with evidence of fat and calcification.
The largest dimension of these lesions is located under the peritoneal fold of the
rectouterine pouch of Douglas.
Located in the pelvic cavity, it is supported by the broad, round and cardinal ligaments, as well as by the
rectouterine and vesicouterine folds.
Secondary screening was considered necessary if a mass of at least 30 mm in length was noted anywhere in the pelvic cavity, if a mass of any size showed a mixed echographic pattern, and/or if ascites measuring 50 mm or more were detected in the
rectouterine pouch.
There are several reports of internal hernias into the
rectouterine pouch and vesicouterine pouch [4, 5].
Douglas pouch is an extension of the peritoneal cavity between the rectum and the back wall of the uterus, which is also known as the
rectouterine pouch [3].