Paracolic Gutter Fluid Collection

Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass.

Paracolic gutter fluid collection.

How to look for peritoneal collections by ultrasound. Where is the fluid. Dense fluid may suggest hemoperitoneum especially in the context of trauma. Fluid collections developing from body and tail of pancreas form in the lesser sac.

As was mentioned earlier fluid collections in the paracolic and left inframesocolic spaces may communicate with the pelvic spaces fig 10. 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. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. 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.

The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify. Pathologic fluid can pass between the supracolic and infracolic compartments via the paracolic gutters the peritoneal spaces lateral to the ascending and descending colon. Secondly we have to realize that any loculated fluid collection due to infection i e. Interfascial spread is another method of communication between the abdomen and pelvis and also allows communication across the midline through the retromesenteric plane.

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. 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. There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen.

Fluid on ct is relatively hypodense dark on ct. 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. Fluid may collect anteriorly as a result of the capillary effect of the narrow space between bowel loops and viscera.

This drainage occurs in much the same way that the gutters on a house draw the rain off the roof. The left medial paracolic gutter. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration.