Free fluid collecting in the left paracolic gutter does not normally track upward into the left subphrenic space, unlike fluid in the right paracolic gutter which reaches Morison's pouch readily. Which peritoneal fold accounts for this difference?

• A Phrenicocolic ligament ✓
• B Falciform ligament
• C Gastrosplenic ligament
• D Splenorenal ligament

Explanation

The phrenicocolic ligament runs from the left colic flexure to the diaphragm opposite ribs 11 and 12. It supports the spleen and acts as a shelf that closes off the upper end of the left paracolic gutter, blocking ascendant spread of infection to the left subphrenic space. On the right there is no equivalent barrier, so the wide right paracolic gutter connects the pelvis directly with Morison's pouch and the right subdiaphragmatic space. The falciform ligament separates the right and left subphrenic spaces.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.