Paracolic Gutter Fluid Collection

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.

Paracolic gutter fluid collection.

Fluid may collect anteriorly as a result of the capillary effect of the narrow space between bowel loops and viscera. Secondly we have to realize that any loculated fluid collection due to infection i e. There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. Paracolic gutters function to drain fluid that leaks from the colon such as infectious matter pus or bile and to prevent infection or damage to the outer margin of the colon.

Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. The left medial paracolic gutter. The main paracolic gutter lies lateral to the colon on each side. How to look for peritoneal collections by ultrasound.

Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. Where is the fluid. The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify. Dense fluid may suggest hemoperitoneum especially in the context of trauma.

This drainage occurs in much the same way that the gutters on a house draw the rain off the roof. Pathologic fluid can pass between the supracolic and infracolic compartments via the paracolic gutters the peritoneal spaces lateral to the ascending and descending colon. The right lateral paracolic gutter. It can be compared to fluid in the gallbladder or stomach.

In a study of patients with ascites from liver disease 92 had ascites around the liver 77 in the pelvis 69 in the paracolic gutters and 63 in morison s pouch. Fluid on ct is relatively hypodense dark on ct. In a supine position gravity causes fluid in the upper abdomen to flow from the left upper quadrant and right paracolic gutter into the right upper quadrant. Fluid collections developing from body and tail of pancreas form in the lesser sac.

Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration. Interfascial spread is another method of communication between the abdomen and pelvis and also allows communication across the midline through the retromesenteric plane. The paracolic gutter is associated with a subphrenic abscess. Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass.