The hepatorenal (Morrison's) pouch is the most dependent part of the peritoneal cavity in the supine position. It communicates with the pelvic peritoneum via which route?

• A Via the right paracolic gutter, which runs along the ascending colon to the right iliac fossa and pelvis ✓
• B Directly through the greater omentum which bridges the two compartments
• C Via the lesser omentum and into the omental bursa toward the pelvis
• D Through the left paracolic gutter only, because the right side is blocked by the liver

Explanation

Morrison's pouch (the hepatorenal recess) communicates with the rest of the peritoneal cavity through the right paracolic gutter — the peritoneal space lateral to the ascending colon on the right. Fluid in Morrison's pouch can track inferiorly along the right paracolic gutter into the right iliac fossa and then into the rectovesical/rectouterine pouch (Pouch of Douglas) in the pelvis. The left paracolic gutter is bounded superiorly by the phrenocolic ligament, which limits free communication with the left subphrenic space. Understanding these routes guides drainage placement in abdominal collections.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.