m Causes:
1- Generalized peritonitis ® localized in the pelvis.
2- Acute salpingitis. 3- Acute parametritis.
4- Acute appendicitis.
mClinical Picture:
1- Tenesmus: due to irritation to the rectum.
2- Frequency: due to irritation to the U.B.
3- P/R® pulging and tenderness in ant. rectal wall.
4- P/V fullness of Douglas pouch.
m Investigations:
Ultrasonogrphy ® detect localized collection.
m Treatment:

Drainage:
Male:
Drained through anterior
wall of the rectum
= Proctotomy

Female:
Drained through posterior
fornix = Posterior colpotomy

SOURCE: DR. AYMAN SALEM'S BOOK
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