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In the video one can see free fluid in the douglas pouch. The pouch of Douglas or rectouterine pouch, is an extension of the postero-inferior reflection of the peritoneal fold between the uterus (anteriorly) and rectum (posteriorly). It is the most inferior aspect of the peritoneal cavity and therefore the first location where free fluid accumulates.Evidence of fluid within the pouch is a common finding, and the underlying cause can be thought of as either physiological or pathological. In this case it the underlying cause is the car accident with an intraperitoneal bleeding.
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Case courtesy of Florian Recker MD