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culdocentesis; colpocentesis
Aspiration of fluid from the cul-de-sac
Indications:
- evaluation of pelvic inflammatory disease
- evaluation of ectopic pregnancy
- evaluation of ovarian cyst
- evaluation of hemoperitoneum
Contraindications:
1) retroflexed uterus
2) mass palpated in cul-de-sac
Clinical significance:
1) non clotting blood suggests hemoperitoneum
2) clear-flowing blood-tinged fluid suggests ovarian cyst
3) purulent fluid suggests pelvic inflammatory disease (PID), appendicitis or diverticular abscess
Notes:
- largely replaced by pelvic ultrasound
General
gynecologic surgery
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 396-397
- Medline Plus: Culdocentesis
http://www.nlm.nih.gov/medlineplus/ency/article/003919.htm
- Medscape: Culdocentesis
http://emedicine.medscape.com/article/83097-overview
- Culdocentesis vs. Colpocentesis
http://www.supercoder.com/articles/articles-alerts/oca/reader-questions-culdocentesis-vs.-colpocentesis/