Sigmoidocele

Sigmoidocele (also known as Pouch of Douglas descent) refers to a condition where the sigmoid colon descends (prolapses) into the lower pelvic cavity. ^[1] This can obstruct the rectum and cause symptoms of obstructed defecation.

Epidemiology

Sigmoidocele normally occurs in females, and is uncommon. ^[1]

Pathophysiology

The phenomenon is caused by a weak section of fascial supports of the vagina (the uterosacral cardinal ligament complex and rectal vaginal septum), which allows a section of peritoneum containing the sigmoid colon to prolapse out of normal position and fall between the rectum and the vagina. ^[2]

Diagnosis

It is not possible to differentiate between a rectocele and a sigmoidocele on vaginal examination. Defecating proctography will demonstrate a sigmoidocele during straining.

References

1. Wexner, edited by Andrew P. Zbar, Steven D. (2010). Coloproctology. New York: Springer. ISBN 978-1-84882-755-4.
2. al.], senior editors, Bruce G. Wolff ... [et (2007). The ASCRS textbook of colon and rectal surgery. New York: Springer. ISBN 0-387-24846-3.