Paracolic Gutter Fluid Collection

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.

Paracolic gutter fluid collection.

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 main paracolic gutter lies lateral to the colon on each side. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.

As was mentioned earlier fluid collections in the paracolic and left inframesocolic spaces may communicate with the pelvic spaces fig 10. Interfascial spread is another method of communication between the abdomen and pelvis and also allows communication across the midline through the retromesenteric plane. The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify. How to look for peritoneal collections by ultrasound.

Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass. Fluid on ct is relatively hypodense dark on ct. Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration. 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.

Where is the fluid. Fluid may collect anteriorly as a result of the capillary effect of the narrow space between bowel loops and viscera. The left medial paracolic gutter. The right lateral paracolic gutter.

It can be compared to fluid in the gallbladder or stomach. Secondly we have to realize that any loculated fluid collection due to infection i e. Dense fluid may suggest hemoperitoneum especially in the context of trauma. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g.

The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. 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 collections developing from body and tail of pancreas form in the lesser sac. The paracolic gutter is associated with a subphrenic abscess.