Pelvic recesses of peritoneal cavity

The pelvic recesses of the peritoneal cavity are defined as the dependent pouches, fossae, and spaces formed by the reflections of the peritoneum over the pelvic organs and structures. These recesses represent the most inferior portions of the peritoneal cavity and serve as potential spaces where fluid can accumulate.

The specific recesses differ between males and females due to anatomical differences in pelvic organs:

• Rectovesical pouch (males): The peritoneum covering the bladder reflects posteriorly onto the rectum, forming a single pouch the rectovesical space which is the most dependent peritoneal recess in males.

• Vesicouterine pouch (females): Located anteriorly between the urinary bladder and the uterus, formed by the anterior peritoneal reflection over the uterus.

• Rectouterine pouch (pouch of Douglas, females): Located posteriorly between the uterus and the rectum. This is the most dependent (inferior) recess of the entire peritoneal cavity in females and is a common site for fluid accumulation, including ascites, blood, and pus.

• Paravesical fossae: Lateral recesses on either side of the bladder, formed by peritoneal reflections over the obliterated umbilical arteries and inferior epigastric vessels. These include the supravesical fossa, medial inguinal fossa, and lateral inguinal fossa.

• Pararectal fossae: Located laterally adjacent to the rectum, bounded posterolaterally by the rectouterine (sacrogenital) folds. These fossae are continuous with the pouch of Douglas.

• Ovarian fossae (females): Peritoneal depressions on the lateral pelvic wall where the ovaries are situated.