Paracolic Gutter Cyst

The right lateral paracolic gutter runs from the superiolateral aspect of the hepatic flexure of the colon down the lateral aspect of the ascending colon and around the cecum.

Paracolic gutter cyst.

These images look quite similar to images of a pseudomyxoma peritonei which was discussed before. Symptoms of cancer spreading in the peritoneum the clinical profile of pseudomyxoma peritonei is normally increasing abdominal circumference and confirmation of mucous in the abdominal cavity jelly belly. The main paracolic gutter lies lateral to the colon on each side. Fluid and fat stranding can be seen extending from the pelvis into the right upper quadrant by way of the paracolic gutter.

In a male patient this is a very uncommon diagnosis. In the clinical setting of primary and secondary. Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. Peritoneal septa and loculated perihepatic fluid may be seen and gallbladder wall thickening may also be depicted fig 14a 14b 40 41.

The paracolic gutter is associated with a subphrenic abscess. But disease history including appendicitis or mucous as coincidental finding are alternative forms of presentation. The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end.