Paracolic Gutter Metastasis

The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon.

Paracolic gutter metastasis.

Paracolic gutters refer to open areas between the wall of the abdomen and the colon. 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. Mucous and attached tumor are usually observed. The left medial paracolic gutter.

It is also known as sulci paracolic and paracolic recesses. Almost 90 of patients with ovarian cancer have peritoneal implants at post mortem and 60 70 have ascites 24 25. Etiologically it means a channel adjacent to the abdominal wall. 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. Between the outer wall of the colon and back side of the abdominal wall there is an open space known as the paracolic gutter. The right paracolic gutter is continuous with the perisplenic space or area around the spleen. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.

Spread of deposits to the right subhepatic and subphrenic spaces is also frequently seen especially in ovarian cancer.