Paracolic gutters

Not to be confused with the paramesenteric gutters, which are recesses between the colon and the root of the mesentery.
Paracolic gutters

Diagram devised by Delépine to show the lines along which the peritoneum leaves the wall of the abdomen to invest the viscera.
Details
Latin sulci paracolici
Identifiers
Dorlands
/Elsevier		 s_28/12769488
TA A10.1.02.424
FMA 76603
Anatomical terminology

The paracolic gutters (paracolic sulci, paracolic recesses) are spaces between the colon and the abdominal wall.

Structure

There are two paracolic gutters:

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. The main paracolic gutter lies lateral to the colon on each side. 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. 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. It is continuous with the peritoneum as it descends into the pelvis over the pelvic brim. Superiorly, it is continuous with the peritoneum which lines the hepatorenal pouch and, through the epiploic foramen, the lesser sac.[1]

Variation

The right paracolic gutter is larger than the left, which together with the partial barrier provided by the phrenicocolic ligament, may explain why right subphrenic collections are more common than left subphrenic collections.[2]

Function

These gutters are clinically important because they allow a passage for infectious fluids from different compartments of the abdomen. For example; fluid from an infected appendix can track up the right paracolic gutter to the hepatorenal recess.

Clinical significance

Bile, pus or blood released from viscera anywhere along its length may run along the gutter and collect in sites quite remote from the organ of origin. In supine patients, infected fluid from the right iliac fossa may ascend in the gutter to enter the lesser sac. In patients nursed in a sitting position, 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. The right paracolic gutter is larger than the left, which together with the partial barrier provided by the phrenicocolic ligament, may explain why right subphrenic collections are more common than left subphrenic collections.[3]

See also

This article uses anatomical terminology; for an overview, see anatomical terminology.

References

  1. ↑ Grays Anatomy 39th Edition. Page No. 1136
  2. ↑ Grays Anatomy 39th Edition. Page No. 1136
  3. ↑ Grays Anatomy 39th Edition. Page No. 1136

External links