The accumulation of fluid in the Douglas space in women in some cases does not have any negative or positive effect on the body. But in some situations, it can signal the development of serious inflammatory reactions. In this regard, in order to get a complete clinical picture, one should undergo an examination recommended by a qualified doctor.
Basic concepts
First you need to figure out what is the Douglas space in women, where it is located and which functions. It is a kind of pocket formed by the peritoneal fold and extending from the posterior uterine wall to the rectum. In women, the Douglas space is the deepest part of the abdominal cavity.
This education received its name thanks to James Douglas, who was an English anatomist who lived in the 18th century and devoted his life to the study of the rectal uterine cavity.
Unlike the male body
Due to its distinctive features, the female body differs from the male in the location of the peritoneum. In men, the peritoneum forms a specific depression between the surfaces of the urinary organ and the rectum. In women, in turn, between the indicated organs is the uterus, also covered with the peritoneum.
In this regard, the formation of two deepening of the peritoneum is noted in the body: between the urinary organ and the uterus, and also between the uterus and the rectum.
Douglas space in women is the most potential area of fluid accumulation. Normally, it should not be much, while it should have a light yellow color, be transparent.
The Douglas space does not bear any specific functions and is a feature of the anatomical structure of the peritoneum in women.
In the case when the liquid becomes cloudy, or pus is present in it, one can judge the presence of inflammation in the body.
Causes of congestion
Liquid and purulent exudate in the douglas space in women can accumulate for several reasons:
- The inflammatory process in the lymph nodes.
- The spread of infectious lesions through the fallopian tubes.
- Injury resulting from an unprofessional abortion.
- Ectopic pregnancy.
- The acute form of paraproctitis.
There can also be detected lymph and blood (if there has been a violation of the integrity of the lymph or blood vessels).
If the results of an ultrasound scan show that fluid is present in the douglas space of women, this may well be the norm. Especially if the volume of fluid is within normal limits, then there is no reason for panic. During the diagnosis, a professional doctor will take into account the general clinic: the presence of pain in the abdominal cavity, dizziness, discharge.
Natural processes
The liquid in the specified space can accumulate against the background of natural processes, which should not scare a woman:
- Excessive fluid may be observed in girls and young girls during early puberty in the cavity. The gynecologist will check the problem and diagnose the norm.
- Menstruation. During menstruation, spotting can be thrown into the Douglas space. In this case, there is no reason for concern either. The endometrium during menstruation, together with the secretions, enters the abdominal cavity.
Currently, despite the fact that appropriate clinical trials are being conducted, there is no exact way to determine the safe volume of fluid that accumulates in the Douglas space. There are suggestions that it should not exceed 20 ml.
Schematically, the Douglas space in women is pictured below.
The space itself has a rather small volume, but the amount of fluid accumulated in it depends on the constitutional characteristics of the female body and the parameters of the small pelvis.
The timing
If fluid is detected in the Douglas space during ultrasound, it is very important to determine the time when it formed. If this happened after ovulation occurred, then, probably, it is here for about 2-3 days.
When the presence of fluid is accompanied by symptoms of the inflammatory process in the pelvic organs, we can assume the spread of inflammation and the occurrence of purulent reactions.
In such a case, a woman should not ignore the results of an ultrasound scan. It is important to undergo an additional examination prescribed by a doctor.
When will a puncture of fluid be required in the douglas space of women?
Examination necessary if there is a suspicion of inflammation
If fluid accumulates in the Douglas space, and the clinical picture is supplemented by abdominal pain, vaginal discharge, dizziness, the gynecologist can recommend the following diagnostic methods and tests:
- A standard laboratory study of blood samples, including the determination of a white blood cell count.
- Laboratory study of urine samples.
- Determination of pain during palpation of certain areas of the pelvis.
- Additional pelvic ultrasound.
- Diagnostic puncture of fluid with its subsequent bacteriological examination.
In cases where the results of a bacteriological examination of the punctured fluid are negative, then pus or blood is not contained in the douglas space. The liquid will be clean, transparent.
Obtaining blood that does not contain clots indicates that bleeding is observed inside the peritoneum, provoked by the occurrence of an ectopic pregnancy, rupture of a cyst or spleen.
When pus is detected in the extracted fluid according to the results of a bacteriological study, the specialist concludes that an inflammatory process is taking place in the female body. That is, only additional examination and analysis can give cause for concern.
We examined the reasons why fluid accumulates in women in the Douglas space.