Paracolic Gutter Metastasis

The left medial paracolic gutter.

Paracolic gutter metastasis.

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. Their deposition and growth occur at particular sites due to relative stasis of ascitic fluid 1 undersurface of the diaphragm due to negative pressure and capillary force omenta tendency to move toward the areas of peritoneal irritation recto uterine space pouch of douglas right lower quadrant region of ileocaecal junction left lower quadrant superior aspect of sigmoid mesocolon and right paracolic gutter are prone for metastatic implants. On ct seeded metastases appear as nodular or plaque like soft tissue masses in association with ascites.

The left gutter runs between the descending colon and the abdominal wall and just like the right gutter empties into the lower abdomen and pelvic area. It is also known as sulci paracolic and paracolic recesses. Paracolic gutters refer to open areas between the wall of the abdomen and the colon. Mucous and attached tumor are usually observed.

Etiologically it means a channel adjacent to the abdominal wall. Almost 90 of patients with ovarian cancer have peritoneal implants at post mortem and 60 70 have ascites 24 25. The right paracolic gutter is continuous with the perisplenic space or area around the spleen. In the greater omentum under the right diaphragm in the paracolic gutters bilaterally around the liver and gallbladder in the abdominal cavity.

Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter.