Medical term: Gossypiboma

I found this in a recent discussion from the New England Journal of Medicine's "Images in Clinical Medicine" as it presented a case of "Gossypiboma in the Pouch of Douglas." Well, I think I'm not alone in asking what's that word, I'm sure it's something like a tumor or a mass in that pouch.

Well, actually it's really a mass caused by a man-made error. The word comes from two unrelated languages, Latin and Swahili. "Gossypium" is the Latin word for "cotton" and "boma" is the Swahili word for "a place of concealment." So literally speaking, "gossypiboma" is "cotton that is in a place of concealment." In other words, a hidden retained surgical sponge.

So how about the pouch of Douglas? This is also called the recto-uterine pouch, the Patrick Douglas bursa, the Ehrhardt-Cole Recess, Douglas cul-de-sac, and Douglas space; and as the first alternative term describes, you won't find this in any male person. The pouch is located within the abdominal cavity and it is the lowest part and an extension of that cavity between the rectum and the uterus. In males, the counterpart is the recto-vesicular pouch (between the rectum and urinary bladder). You can see this in the picture, just follow the line that has the label, "Excavatio recto-uterina." You won't miss it.

The Douglas pouch is used in end-stage renal failure dialysis where the tip of the catheter is placed, and it's also a common location where spread of diseases like infections, bleeding, and tumours can occur.