Paracolic gutters

The paracolic gutters (paracolic sulci, paracolic recesses) 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, between the colon and the lateral abdominal wall. 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.

There are two main lateral paracolic gutters:

• The right lateral paracolic gutter: runs from the superolateral aspect of the hepatic flexure of the colon, down the lateral aspect of the ascending colon, and around the caecum. It is continuous with the peritoneum as it descends into the pelvis over the pelvic brim. Superiorly, it is continuous with the peritoneum which lines the hepatorenal pouch and, through the epiploic foramen, the lesser sac.

• The left lateral paracolic gutter: runs from the left colic flexure adjacent to the lateral wall of the descending colon and medial to the left lateral part of the anterior abdominal wall, to its termination at the at the lateral edge of the sigmoid mesocolon. Unlike the right lateral paracolic gutter, the left lateral paracolic gutter is limited superiorly by the phrenicocolic ligament. Unlike the right paracolic gutther, the left lateral paracolic gutter does not communicate with the supracolic compartment.