The Spread and Localization of Acute Intraperitoneal Effusions

Major routes of spread of intraperitoneal exudates and subsequent localizations of abscesses at sites remote from their source were determined primarily by peritoneography and selected clinical cases. Fluid ascends the right external paracolic gutter from the pelvic cavity to enter Morrison's pouch before progressing to the right subphrenic space. The phrenicocolic ligament restricts flow in either direction between the left paracolic gutter and perisplenic space. The mesenteric attachments themselves may serve as pathways for the spread of exudates. Extravasated pancreatic enzymes may pass down the length of the small-bowel mesentery to the ileocecal region.