Right Paracolic Gutter Ct

This is discussed more fully in chapter 108.

Right paracolic gutter ct.

There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. The connection between the left paracolic gutter and the left subphrenic space is partially limited by the phrenicocolic ligament. Ct these hernias can often be confidently diagnosed as a cluster of bowel loops usually ileal located posteriorly and laterally to the normal cecum occasionally extending into the right paracolic gutter. It is continuous with the peritoneum as it descends into the pelvis over the pelvic brim.

The main paracolic gutter lies lateral to the colon on each side. Courtesy of ghahremani gg san diego ca view larger version 103k. Its origin lies on the right side origin of the right paracolic gutter lies at the ascending portion of the colon at the right hepatic flexure or the point where the ascending colon turns at a right angle to form the transverse colon. The inframesocolic space also contains paracolic gutters which are peritoneal recesses that are inferolateral extensions of their corresponding inframesocolic spaces on the posterior abdominal wall lateral to the ascending and descending colon respectively.

The right lateral paracolic gutter runs from the superolateral aspect of the hepatic flexure of the colon down the lateral aspect of the ascending colon and around the caecum. B ct scan of the pelvis shows that the bowel loops of the oral aspect of the intestine are dilated arrowhead and the bowel loops of the anal aspect are collapsed arrow. Fluid in the right paracolic gutter which structure represents the main communication between the upper and lower abdominal compartments reaches morison s pouch and subsequently the right subphrenic space. Contrast enhanced axial ct scan shows loops of small bowel arrow posterior and lateral to cecum asterisk in right paracolic gutter producing small bowel obstruction.

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. Laparotomy was performed 6 hours after ct. Figure 110 2 common pathways of intraperitoneal fluid spread. These images look quite similar to images of a pseudomyxoma peritonei which was discussed before.

In a male patient this is a very uncommon diagnosis. The right paracolic gutter is larger than the left and communicates freely with the right subphrenic space.