Pancreatic Drainage Into Paracolic Gutter

These collections are in close proximity to posterior wall of the stomach and thus amenable for internal drainage into the stomach.

Pancreatic drainage into paracolic gutter.

Best practice advice 9. Of necrotic collections that extend into the paracolic gutter. When disruption of the pancreatic duct with leak was evident a pancreatic duct stent was placed using standard endoscopic techniques 25. The paracolic gutters slope into the subhepatic and subdiaphragmatic spaces superiorly and over the pelvic brim inferiorly.

The main paracolic gutter lies lateral to the colon on each side. This patient was asymptomatic during the last follow up. Both paracolic gutters run laterally along the back side of the abdominal wall and are situated between the abdominal wall and the outer margin of the colon. Pfcs may also extend to left paracolic space.

Walled off pancreatic necrosis won is a sequelae of acute pancreatitis that requires debridement once infected. The right lateral gutter is much larger and allows for greater drainage than the left gutter. Two patients patients 8 and 12 developed recurrent pseudocysts after 2 and 4 months respectively. In cases where necrosis extends into one or both paracolic gutters and or into the pelvis the dependent portions of the collection will not be able to drain effectively through superiorly located transmural endoscopic.

When other peripancreatic collections expanded widely to paracolic. The proximal tip of the pancreatic duct stent was advanced either well into the collection or bridged the site of pancreatic duct disruption. The left medial paracolic gutter. However peripancreatic collections that extend to the paracolic gutter or lesser sac are more challenging to treat endoscopically.

Paracolic gutters help keep infectious material away from the body s internal organs. Consecutive patients with symptomatic won extending into the retroperitoneum were included in a prospective registry. Fluid collections developing from body and tail of pancreas form in the lesser sac. Percutaneous drainage should be employed when endoscopic drainage is unavailable unsuccessful or not technically feasible.

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 a supine patient the peritoneal fluid tends to collect under the. Self expanding metal stents in the form of lumen apposing.