The peritoneum is a thin serous membrane which lines the inside of the pelvic and abdominal cavities. In simplistic terms it is probably best to imagine a pelvis containing the bladder, uterus and rectum (Fig. 1.4) and note that the peritoneum is a layer placed over these organs in a single sheet. This complete layer is then pierced by both the fallopian tubes and the ovaries on each side. Posteriorly the rectum also pierces the peritoneum connecting to the sigmoid colon and the area between the posterior surface of the uterus and its supporting ligaments and the rectum is called the Pouch of Douglas. This particular area is important in gynaecology as the place where gravity dependent fluid collects. As a result this is where blood is found in ectopic pregnancies, pus in infections and endometriosis which has been caused by retrograde menstruation (Sampsons theory).
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