Paracolic Gutter Pancreatitis

There is moderate and diffuse peripancreatic fat stranding.

Paracolic gutter pancreatitis.

The paracolic gutter is associated with a subphrenic abscess. The main paracolic gutter lies lateral to the colon on each side. Recently endoscopic necrosectomy has become the mainstay for management. The adjacent second and third segments of the duodenum demonstrate mural thickening in keeping with reactive change.

Walled off pancreatic necrosis won is a sequelae of acute pancreatitis that requires debridement once infected. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. Transcutaneous endoscopic necrosectomy through a fully covered metal esophageal stent transgastric endoscopic necrosectomy with nasocystic lavage is accepted as one of the standards of care for the management of walled off necrosis secondary to acute pancreatitis. Cleaning the paracolic gutter.

Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. However peripancreatic collections that extend to the paracolic gutter or lesser sac are more challenging to treat endoscopically. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.