A patient presents with a pelvic abscess following perforated appendicitis. Through which peritoneal pathway did the infected fluid most likely travel from the right iliac fossa to the rectovesical pouch?

• A Right paracolic gutter ✓
• B Left paracolic gutter
• C Intersigmoid recess
• D Supravesical fossa

Explanation

The right paracolic gutter communicates freely with the hepatorenal recess superiorly and the pelvic cavity inferiorly. The left paracolic gutter is partially blocked by the phrenicocolic ligament. In supine patients, infected fluid from the right lower quadrant tracks up the right paracolic gutter or down into the pelvis via this route.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.