Paracolic Gutter Cyst

In the clinical setting of primary and secondary.

Paracolic gutter cyst.

In a male patient this is a very uncommon diagnosis. Fluid and fat stranding can be seen extending from the pelvis into the right upper quadrant by way of the paracolic gutter. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. But disease history including appendicitis or mucous as coincidental finding are alternative forms of presentation.

The right lateral paracolic gutter runs from the superiolateral aspect of the hepatic flexure of the colon down the lateral aspect of the ascending colon and around the cecum. The paracolic gutter is associated with a subphrenic abscess. These images look quite similar to images of a pseudomyxoma peritonei which was discussed before. The main paracolic gutter lies lateral to the colon on each side.

There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. Peritoneal septa and loculated perihepatic fluid may be seen and gallbladder wall thickening may also be depicted fig 14a 14b 40 41. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity.