Paracolic Gutter Fluid Collection

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.

Paracolic gutter fluid collection.

Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass. The main paracolic gutter lies lateral to the colon on each side. Fluid on ct is relatively hypodense dark on ct. It can be compared to fluid in the gallbladder or stomach.

The paracolic gutter is associated with a subphrenic abscess. 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. How to look for peritoneal collections by ultrasound.

The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify. 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. Pathologic fluid can pass between the supracolic and infracolic compartments via the paracolic gutters the peritoneal spaces lateral to the ascending and descending colon.

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. Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration. 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.

As was mentioned earlier fluid collections in the paracolic and left inframesocolic spaces may communicate with the pelvic spaces fig 10. There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. Where is the fluid. Secondly we have to realize that any loculated fluid collection due to infection i e.

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. 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 lateral paracolic gutter. Interfascial spread is another method of communication between the abdomen and pelvis and also allows communication across the midline through the retromesenteric plane.