Cul-de-sac hernia

A cul-de-sac hernia (also termed a peritoneocele) is a herniation of peritoneal folds into the rectovaginal septum (in females), or the rectovesical septum (in males). The herniated structure is the recto-uterine pouch (pouch of Douglas) in females, or the rectovesical pouch in males. The hernia descends below the proximal (upper) third of the vagina in females, or, according to another definition, below the pubococcygeal line (PCL).

According to a consensus statement by the USA, Australia and the UK, a cul-de-sac hernia / peritoneocele is defined as "a protrusion of the peritoneum between the rectum and vagina that does not contain any abdominal viscera" (organs). An enterocele is defined as "a protrusion of the peritoneum between the rectum and vagina containing the small intestine." A sigmoidocele is defined as "a protrusion of the peritoneum between the rectum and vagina that contains the sigmoid colon." An omentocele is defined as "a protrusion of the omentum between the rectum and the vagina." As such, peritoneocele, enterocele, sigmoidocele, and omentocele could be considered as types of cul-de-sac hernia.