What causes fluid collection in the pouch of Douglas?

Question

Hello doctor,

A loculated fluid collection is noted in the pouch of Douglas measuring about 10.1 x 7.0 x 5 cm. It is seen indenting on the adjacent rectum and the posterior wall of the uterus. The uterus reveals arcuate morphology with the cervix appearing bulky. What does it mean? Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

Kindly send a detailed scan and your previous gynecological history, be, it medical or surgical. Do you have any symptoms or any pain, bleeding, etc? It seems that there is a fluid collection with locules in it that suggest that it is a cystic, loculated ovary which was seen in the pouch of Douglas meaning it is an ovarian cyst that is emasculated in the pouch of Douglas. Another meaning could be some torsion tumor with fluid around it that need evaluation With it need immediate surgery or not .or just blood tests like Ca 125 to check for any malignancy is there or not. Your history and presenting complaints matter. In the case of abdominal pain, it could be a torsion cyst, ectopic or pelvic infection, polycystic ovary with infection, etc. In a chronic situation, you need blood tests like Ca 125 and other tumor markers to exclude pregnancy whereas in an acute situation need an emergency diagnostic laparoscopy or laparotomy. The large cyst could rupture and can cause infection, sepsis, torsion, etc. Cysts or tumors are always sent for histopathology. History, presentation, and symptoms need to correlate. I hope u get my point.

Thank you.