Left Paracolic Gutter Nodule

The left medial paracolic gutter.

Left paracolic gutter nodule.

A less obvious medial paracolic gutter may be formed especially on the right side if the colon possesses a short mesentery for part of its length. The left lateral paracolic gutter is on the left side of the abdominal cavity between the outer wall of the descending colon and posterior abdominal wall. 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. 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. The right paracolic gutter is continuous with the perisplenic space or area around the spleen. Most of the fluid ascends via the right paracolic gutter into the right subdiaphragmatic space because the left paracolic gutter is shallow and discontinuous with the left subdiaphragmatic space at the phrenicocolic ligament and because direct passage from the right to left subdiaphragmatic space is prevented by the falciform ligament fig 1b 3 5. As the left paracolic gutter is shallow and discontinuous with left subdiaphragmatic space at the phrenicocolic ligament most of the fluid takes path through the right paracolic gutter.

Completion of the circulatory pathway takes place caudally by redirection of fluid into the pelvis through the inframesocolic compartment13 fig. Consequently the majority of fluid flows into the right paracolic gutter.