The pouch of Douglas (rectouterine pouch) is the most dependent peritoneal recess in the female pelvis in the erect position. Through which route is it most accessible for diagnostic aspiration?

• A Suprapubic abdominal route
• B Anterior fornix of the vagina
• C Lateral fornix via parametrium
• D Posterior fornix of the vagina (culdocentesis) ✓

Explanation

The rectouterine pouch is directly adjacent to the posterior fornix of the vagina, with only the thin posterior vaginal wall and peritoneum intervening. Culdocentesis (colpocentesis) involves inserting a needle through the posterior fornix to aspirate fluid from this pouch — used diagnostically for ectopic pregnancy rupture (blood) or pelvic abscess (pus). This relationship also explains why perforations of the posterior fornix communicate with the peritoneal cavity.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.