Paracolic Gutter Fluid Ct

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

Paracolic gutter fluid ct.

The ascending colon a is displaced anteriorly and ascites arrowhead is seen in the right paracolic gutter. Given the nonspecific clinical manifestations computed tomography ct is commonly the first imaging examination performed. 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. Etiologically it means a channel adjacent to the abdominal wall.

Fluid on ct is relatively hypodense dark on ct. 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. Small amounts of ascitic fluid localize in the right perihepatic space the posterior subhepatic space i e morison s pouch and the pouch of douglas. Ascites is well demonstrated by ct.

When larger amounts of ascites are present the fluid accumulates in the paracolic gutters causing progressive centralization of bowel loops. The paracolic gutters paracolic sulci paracolic recesses are spaces between the colon and the abdominal wall. It is the depression between the postero lateral wall of the abdomen and the lateral margins of the ascending and descending colon. The right lateral paracolic gutter runs from the superiolateral aspect of the hepatic flexure of the colon down the lateral aspect of the ascending colon and around the cecum.

It can be compared to fluid in the gallbladder or stomach. 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. Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter. General ct findings of early and late stage pid include thickening of the uterosacral ligaments pelvic fat stranding with obscuration of fascial planes reactive lymphadenopathy and pelvic free fluid.

Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. Fluid from the stomach duodenum or gallbladder may run down the gutter to collect in the right iliac fossa or pelvis and may mimic acute appendicitis or form a pelvic abscess. It is also known as sulci paracolic and paracolic recesses. Laparotomy was performed 6 hours after ct.

Dense fluid may suggest hemoperitoneum especially in the context of trauma.