Paracolic Gutter Ultrasound

In this section ultrasound ultrasound education faculty image of the fortnight toggle section.

Paracolic gutter ultrasound.

It is smaller than the right paracolic gutter. The left paracolic gutter is a component of the left inframesocolic space partially separated from the left subphrenic spaces by the phrenicocolic ligament. It is also known as sulci paracolic and paracolic recesses. Ultrasound or mr depict these septations better than ct.

Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter. In a male patient this is a very uncommon diagnosis. Blood in the peritoneal cavity from trauma is often first seen in the right paracolic gutter at the inferior tip of the liver. 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. Pus in the paracolic gutter and in douglas pouch and debris filled bladder. Ultrasound images clips appendicitis with perforation. Your fast exam is incomplete if you do not visualize this area.

The left medial paracolic gutter. It is the depression between the postero lateral wall of the abdomen and the lateral margins of the ascending and descending colon. Fluid may sit within the peritoneal space or paracolic gutters or may be interposed between bowel loops or around solid organs e g. Etiologically it means a channel adjacent to the abdominal wall.

Ultrasound is the diagnostic modality of choice for the initial screening of unstable blunt trauma patients for peritoneal free fluid. Both paracolic spaces are in continuity with the pelvic peritoneal spaces. Ultrasound is variably sensitive depending on the size of the patient and the operator. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.

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