Paracolic Gutter Ultrasound

Pus in the paracolic gutter and in douglas pouch and debris filled bladder. It is also known as sulci paracolic and paracolic recesses. Ultrasound or mr depict these septations better than ct.

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Ultrasound is variably sensitive depending on the size of the patient and the operator.

Paracolic gutter ultrasound.

Blood in the peritoneal cavity from trauma is often first seen in the right paracolic gutter at the inferior tip of the liver. Abdominal case of the week cardiac ivc miscellaneous highlights procedure highlights lung ob gyn trauma soft tissue vascular msk. Etiologically it means a channel adjacent to the abdominal wall. Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter.

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. It is smaller than the right paracolic gutter. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. The left paracolic gutter is a component of the left inframesocolic space partially separated from the left subphrenic spaces by the phrenicocolic ligament.

Ultrasound is the diagnostic modality of choice for the initial screening of unstable blunt trauma patients for peritoneal free fluid. Your fast exam is incomplete if you do not visualize this area. In a male patient this is a very uncommon diagnosis. In this section ultrasound ultrasound education faculty image of the fortnight toggle section.

The main paracolic gutter lies lateral to the colon on each side. There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. It is the depression between the postero lateral wall of the abdomen and the lateral margins of the ascending and descending colon. The left medial paracolic gutter.

Ultrasound images clips appendicitis with perforation. In thin patients relatively small volume of fluid can be found. A less obvious medial paracolic gutter may be formed especially on the right side if the colon. Both paracolic spaces are in continuity with the pelvic peritoneal spaces.

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