Right Paracolic Gutter Ultrasound

Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g.

Right paracolic gutter ultrasound.

Ultrasound is variably sensitive depending on the size of the patient and the operator. The right lateral paracolic gutter. Therefore others refer to the left lower quadrant llq as the typical puncture point. Visualize the left subdiaphragmatic space the most important area in the left upper quadrant splenorenal space and left paracolic gutter.

Fluid and fat stranding can be seen extending from the pelvis into the right upper quadrant by way of the paracolic gutter. 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. Abdominal case of the week cardiac ivc miscellaneous highlights procedure highlights lung ob gyn trauma soft tissue vascular msk. The right lateral paracolic gutter runs along the right side of the cavity of the abdomen.

In this section ultrasound ultrasound education faculty image of the fortnight toggle section. However the patient with ascites may have atypical anatomy due to varying dimensions of the spleen and liver in different pathology states. Therefore some physicians favor the right paracolic gutter approach. The main paracolic gutter lies lateral to the colon on each side.

Paracolic gutters refer to open areas between the wall of the abdomen and the colon. 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. Figure 110 2 common pathways of intraperitoneal fluid spread. B left upper quadrant window.

In thin patients relatively small volume of fluid can be found. Visualize the right subdiaphragmatic space hepatorenal recess morison pouch the most sensitive recess for upper abdominal free fluid and the right paracolic gutter. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. Peritoneal septa and loculated perihepatic fluid may be seen and gallbladder wall thickening may also be depicted fig 14a 14b 40 41.

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. This is discussed more fully in chapter 108.