Paracolic Gutter Pancreatitis

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

Paracolic gutter pancreatitis.

The right and left paracolic gutter are connected to subphrenic spaces proximally and to the pelvic area at the distal end. The left medial paracolic gutter. Cleaning the paracolic gutter. 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.

Infected peritoneal fluids get a passageway through these gutters to other compartments of the abdominal cavity. 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. There is moderate and diffuse peripancreatic fat stranding.

A less obvious medial paracolic gutter may be formed especially on the right side if the colon. Recently endoscopic necrosectomy has become the mainstay for management. There is a moderate volume of free intraabdominal fluid with pockets scattered through the mesentery and pooling in the paracolic gutters.