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.

This drainage occurs in much the same way that the gutters on a house draw the rain off the roof. How to look for peritoneal collections by ultrasound. Fluid on ct is relatively hypodense dark on ct. Where is the fluid.

As was mentioned earlier fluid collections in the paracolic and left inframesocolic spaces may communicate with the pelvic spaces fig 10. Magdy said anatomy series abdomen 12 subphrenic spaces and paracolic gutters v1 duration. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.

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

It can be compared to fluid in the gallbladder or stomach. The paracolic gutter is associated with a subphrenic abscess. The necrosed pancreatic parenchyma and or peripancreatic fatty tissue is present within the fluid collection in won and may gradually liquify. The main paracolic gutter lies lateral to the colon on each side.

Fluid may collect anteriorly as a result of the capillary effect of the narrow space between bowel loops and viscera. 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. 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.

Interfascial spread is another method of communication between the abdomen and pelvis and also allows communication across the midline through the retromesenteric plane. Fluid collections developing from body and tail of pancreas form in the lesser sac. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. Abscess or as a result of pancreatitis perforation or bile peritonitis can simulate a cystic mass.