A moderate amount of fluid in the cul-de-sac (black arrows) is secondary to rupture of the corpus luteum in the right ovary (white arrow). Ascitic fluid or blood may settle in this region. The nonovulatory left ovary (black arrowhead) is more homogeneous than the right and has lower attenuation due to fluid-filled follicles. Echogenic fluid in the cul-de-sac is highly suggestive of a ruptured ectopic pregnancy. Differentiation of clear serous fluid from hemorrhagic or exudative fluid by identifying … 3) An acute bleed may be very echogenic and blend in with the pelvic fat in the cul-de-sac and be missed unless you're specifically looking for it. These findings are highly suspicious for ruptured tubal pregnancy. )It is near the posterior fornix of the vagina.. Ultrasound – Limited Pelvis Evaluation . In the absence of free fluid, the cul-de-sac is difficult to visualize sonographically. Note the enhanced collapsed wall of the ruptured corpus luteum. A small amount of anechoic fluid in the cul-de-sac is physiologic. The space between the upper vagina and the rectum is called the cul-de-sac. It lies posterior to the uterus and anterior to the rectum. Endometriosis here often causes fusion of the rectum and the vagina which can result in severe pain with intercourse or with bowel movements. SCOPE: Applies to all ultrasound pelvis studies performed in Imaging Services / Radiology ( The pouch on the other side of the uterus is the vesico-uterine pouch. Why doctor ultrasound cul de sac Ultrasound showed sequelae of the pancreas what does this mean Download Here Free HealthCareMagic App to Ask a Doctor. To check for an ectopic pregnancy 2. In women, the recto-uterine pouch is the deepest point of the peritoneal cavity. Minimal fluid in the cul de sac means there is some fluid collection or reversal flow of the blood. There is a moderate amount of mixed echoes in the cul-de-sac (yellow oval), consistent with clot/blood. All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. PURPOSE: A targeted evaluation of any part of the uterus (myometrium and endometrium), adnexa (ovaries and fallopian tubes), and /or cul-de-sac in non-pregnant women , following up a previous imaging finding . It is normal to have approximately 1 to 3 ml (or mL) of fluid in the recto-uterine pouch throughout the menstrual cycle. myomas, polyps, adhesions, and congenital anomalies) as well as limited information on tubal patency. A small amount of fluid or blood following delivery is normally present. The characteristics of endometriosis of the posterior cul-de-sac or rectovaginal septum at transvaginal ultrasound have been described [8, 11, 12] as a heterogeneous, hypoechoic, sometimes spiculated mass arising from the serosal surface of the rectosigmoid [13, 14].Female patients with pelvic symptoms often undergo transvaginal ultrasound as the first imaging technique. The cul-de-sac is the space between the uterus and the rectum and is the most dependent portion of the pelvis. 2) Signs of an ectopic include adnexal masses, complex fluid, a ring of echogenic decidualized tissue involving the fallopian tube (tubal ring sign) or fluid in the cul-de-sac orMorrison's pouch. A pelvic sonogram is usually performed for these reasons: 1. Transabdominal longitudinal pelvic ultrasound image shows empty endometrial cavity (blue arrow), with a distended tubal structure (green box), posterior to the uterus. To check for bleeding into the pelvic region after surgery 4. 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