Paracolic Gutter Pancreatitis

Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity.

Paracolic gutter pancreatitis.

There is a moderate volume of free intraabdominal fluid with pockets scattered through the mesentery and pooling in the paracolic gutters. There is moderate and diffuse peripancreatic fat stranding. Recently endoscopic necrosectomy has become the mainstay for management. The adjacent second and third segments of the duodenum demonstrate mural thickening in keeping with reactive change.

Cleaning the paracolic gutter. Walled off pancreatic necrosis won is a sequelae of acute pancreatitis that requires debridement once infected. The main paracolic gutter lies lateral to the colon on each side. The left medial paracolic gutter.

Transcutaneous endoscopic necrosectomy through a fully covered metal esophageal stent transgastric endoscopic necrosectomy with nasocystic lavage is accepted as one of the standards of care for the management of walled off necrosis secondary to acute pancreatitis. The paracolic gutter is associated with a subphrenic abscess. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end.