cul-de-sac hernia | |
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Other names | peritoneocele (when contains only peritoneum), omentocele (when contains omental fat),[1] enterocele (when contains small bowel),[2] sigmoidocele (when contains sigmoid colon).[2] |
Specialty | Colorectal surgery, Gynecology |
A cul-de-sac hernia (also termed a peritoneocele) is a herniation of peritoneal folds into the rectovaginal septum (in females),[2] or the rectovesical septum (in males). The herniated structure is the recto-uterine pouch (pouch of Douglas) in females,[2] or the rectovesical pouch in males. The hernia descends below the proximal (upper) third of the vagina in females,[2] or, according to another definition, below the pubococcygeal line (PCL).[3][note 1]
According to a consensus statement by the USA, Australia and the UK,[note 2] a cul-de-sac hernia / peritoneocele is defined as "a protrusion of the peritoneum between the rectum and vagina that does not contain any abdominal viscera" (organs).[4] An enterocele is defined as "a protrusion of the peritoneum between the rectum and vagina containing the small intestine."[4] A sigmoidocele is defined as "a protrusion of the peritoneum between the rectum and vagina that contains the sigmoid colon."[4] An omentocele is defined as "a protrusion of the omentum between the rectum and the vagina."[4] As such, peritoneocele, enterocele, sigmoidocele, and omentocele could be considered as types of cul-de-sac hernia.[3][4]
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