Paracolic Gutter Metastasis

The main paracolic gutter lies lateral to the colon on each side.

Paracolic gutter metastasis.

The left gutter runs between the descending colon and the abdominal wall and just like the right gutter empties into the lower abdomen and pelvic area. Almost 90 of patients with ovarian cancer have peritoneal implants at post mortem and 60 70 have ascites 24 25. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.

In the greater omentum under the right diaphragm in the paracolic gutters bilaterally around the liver and gallbladder in the abdominal cavity. Spread of deposits to the right subhepatic and subphrenic spaces is also frequently seen especially in ovarian cancer. On ct seeded metastases appear as nodular or plaque like soft tissue masses in association with ascites. The right paracolic gutter is continuous with the perisplenic space or area around the spleen.

Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter. Etiologically it means a channel adjacent to the abdominal wall. The left medial paracolic gutter. Mucous and attached tumor are usually observed.

It is also known as sulci paracolic and paracolic recesses.