Fluid In The Left Paracolic Gutter

The main paracolic gutter lies lateral to the colon on each side.

Fluid in the left paracolic gutter.

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 paracolic gutter is associated with a subphrenic abscess. It can be compared to fluid in the gallbladder or stomach. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g.

Fluid on ct is relatively hypodense dark on ct. The left medial paracolic gutter. The left medial paracolic gutter. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.

The main paracolic gutter lies lateral to the colon on each side. 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 right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity.

Dense fluid may suggest hemoperitoneum especially in the context of trauma. Presence of large amounts of free intraperitoneal fluid in the distal aspect of the left paracolic gutter. Fluid in the pelvis may ascend the left paracolic gutter 5 but is stopped by the phrenicocolic ligament pcl. There are really three places where free fluid can potentially collect in the left upper quadrant the subphrenic space between spleen and diaphragm splenorenal recess between spleen and kidney and left paracolic gutter inferior to spleen.

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. In the abdominal cavity fluid leaches from the colon into either the left or the right lateral gutter and then drains down the gutter into the pelvic area. Fluid in the left inframesocolic space 3 seeks the pelvis directly or is deposited on the superior aspect of the sigmoid mesocolon and then flows into the pelvis 4. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.