Douglas abscess is an accumulation of pus in Douglas space, that is, in the pocket of the peritoneal cavity in the pelvic area between the rectum and the bladder (in men) or the uterus (in women). One of the forms of local limited peritonitis (see). Most often it occurs as a postoperative complication of perforated appendicitis (see), but can develop with any purulent process in the abdominal cavity, especially if the operation did not completely dry the pelvic cavity. Signs: pain in the rectum area , increasing temperature, especially in the evenings, diarrhea . When the digital rectal examination revealed painful protrusion of the anterior wall of the rectum, in the initial stages of dense ( infiltration ), and then with a softening in the center.
Treatment is the opening of a rectal abscess after a test puncture. Drainage is inserted into the cavity of the abscess, leading it out through the anus. After the operation, opium tincture is prescribed in 7 drops 3 times a day for 2 days. Daily dressing changes and monitoring of drainage are necessary so that it ensures a good outflow of pus. In women, a Douglas abscess is dissected through the vagina (see Colpotomy).