Paracolic Gutter Hematoma

The main paracolic gutter lies lateral to the colon on each side.

Paracolic gutter hematoma.

There is a multi cystic mass extending from the pelvis along the right paracolic gutter to the upper abdomen. The paracolic gutter is associated with a subphrenic abscess. The right lateral gutter is much larger and allows for greater drainage than the left gutter. In a male patient this is a very uncommon diagnosis.

Open in a separate window fig. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. The right paracolic gutter is larger than the left and communicates freely with the right subphrenic space.

Urgent laparotomy revealed an extensive hemoperitoneum. Paracolic gutters help keep infectious material away from the body s internal organs. Thus centrally located triangular areas of high attenuation abdominal fluid should prompt a search for intraperitoneal bowel or mesenteric injury 7 8. These images look quite similar to images of a pseudomyxoma peritonei which was discussed before.

Spontaneous liver haematoma as a result of thrombolytic therapy. Role of computed tomography in evaluation of ascites. Spontaneous abdominal hemorrhage is defined as the presence of intraabdominal hemorrhage from a nontraumatic and noniatrogenic cause. Both paracolic gutters run laterally along the back side of the abdominal wall and are situated between the abdominal wall and the outer margin of the colon.

The left medial paracolic gutter. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. A less obvious medial paracolic gutter may be formed especially on the right side if the colon. Postoperative computed tomography scan of the abdomen showing extensive hemoperitoneum below the spleen in the left paracolic gutter in front of urinary bladder measuring 12 cm in dimension and a distended rectum measuring 8 5 5.

Common sources of spontaneous abdominal hemorrhage are visceral hepatic splenic renal and adrenal gynecologic coagulopathy related and vascular. The retroperitoneal hematoma measured 13 4 mm diameter and severely compressed the inferior vena cava ivc fig. The paracolic spaces gutters are located lateral to the peritoneal reflections of the left and right sides of the colon fig 8a.