The paracolic gutters (paracolic sulci, paracolic recesses) are peritoneal recesses – spaces between the colon and the

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the ...

Structure

There are two paracolic gutters: * The right lateral paracolic gutter. * The left medial paracolic gutter. 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 superiolateral aspect of the hepatic flexure of the colon, down the lateral aspect of the ascending colon, and around the cecum. 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.Grays Anatomy 39th Edition. Page No. 1136

Variation

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

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 Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection ...

, or

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...

released from

viscera In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a f ...

anywhere along its length may run along the paracolic gutter, and collect in sites quite remote from the organ of origin. In

supine In grammar, a supine is a form of verbal noun used in some languages. The term is most often used for Latin, where it is one of the four principal parts of a verb. The word refers to a position of lying on one's back (as opposed to ' prone', l ...

patients, infected fluid from the

right iliac fossa The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...

may ascend in the paracolic gutter to enter the

lesser sac The lesser sac, also known as the omental bursa, is a part of the peritoneal cavity that is formed by the lesser and greater omentum. Usually found in mammals, it is connected with the greater sac via the omental foramen or ''Foramen of Winsl ...

. In patients nursed in a sitting position, fluid from the

stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...

, duodenum, or

gallbladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...

may run down the paracolic gutter to collect in the right iliac fossa or pelvis. This may mimic

acute appendicitis Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a rupt ...

or form a pelvic abscess. The left paracolic gutter is larger than the right, which together with the partial barrier provided by the phrenicocolic ligament (also known as Hensing's ligament), may explain why left subphrenic collections are more common than right subphrenic collections.

References

External links