Paracolic Gutter Fluid Collection

The left medial paracolic gutter.

Paracolic gutter fluid collection.

It can be compared to fluid in the gallbladder or stomach. Pathologic fluid can pass between the supracolic and infracolic compartments via the paracolic gutters the peritoneal spaces lateral to the ascending and descending colon. Dense fluid may suggest hemoperitoneum especially in the context of trauma. The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify.

Fluid may collect anteriorly as a result of the capillary effect of the narrow space between bowel loops and viscera. Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. Fluid collections developing from body and tail of pancreas form in the lesser sac.

The paracolic gutter is associated with a subphrenic abscess. There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. 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. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity.

How to look for peritoneal collections by ultrasound. As was mentioned earlier fluid collections in the paracolic and left inframesocolic spaces may communicate with the pelvic spaces fig 10. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. The right lateral paracolic gutter.

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. Secondly we have to realize that any loculated fluid collection due to infection i e. Fluid on ct is relatively hypodense dark on ct. This drainage occurs in much the same way that the gutters on a house draw the rain off the roof.

Where is the fluid. The main paracolic gutter lies lateral to the colon on each side. Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass. A less obvious medial paracolic gutter may be formed especially on the right side if the colon possesses a short mesentery for part of its length.