Right Paracolic Gutter 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.

Right paracolic gutter ct.

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 ascending colon a is displaced anteriorly and ascites arrowhead is seen in the right paracolic gutter. 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. The connection between the left paracolic gutter and the left subphrenic space is partially limited by the phrenicocolic ligament.

The right lateral paracolic gutter runs along the right side of the cavity of the abdomen. Figure 110 2 common pathways of intraperitoneal fluid spread. These images look quite similar to images of a pseudomyxoma peritonei which was discussed before. 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.

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 right paracolic gutter is larger than the left and communicates freely with the right subphrenic space.

This is discussed more fully in chapter 108. In a male patient this is a very uncommon diagnosis. Laparotomy was performed 6 hours after ct. It is continuous with the peritoneum as it descends into the pelvis over the pelvic brim.

There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.