Paracolic Gutter Pancreatitis

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

Paracolic gutter pancreatitis.

The paracolic gutter is associated with a subphrenic abscess. Walled off pancreatic necrosis won is a sequelae of acute pancreatitis that requires debridement once infected. The left medial paracolic gutter. 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. There is moderate and diffuse peripancreatic fat stranding. The right and left paracolic gutters are peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon. A less obvious medial paracolic gutter may be formed especially on the right side if the colon.

The main paracolic gutter lies lateral to the colon on each side. Cleaning the paracolic gutter. However peripancreatic collections that extend to the paracolic gutter or lesser sac are more challenging to treat endoscopically.