The infracolic compartment is the portion of the peritoneal cavity below the transverse mesocolon, containing the small bowel loops, the ascending and descending colonic segments (below the transverse colon), and the sigmoid colon. It is divided by the root of the mesentery into right and left infracolic spaces.
The infracolic compartment is the primary site of small bowel perforation, mesenteric ischaemia, and peritonitis. In laparoscopy, the infracolic space is entered after dividing the gastrocolic omentum. Free fluid in the infracolic compartment on FAST ultrasound indicates bowel injury or mesenteric vessel haemorrhage. The right infracolic space communicates with the right paracolic gutter and pelvis, making it the route of abscess spread from appendicitis.
Infection spreading through the infracolic compartment from small bowel perforation or mesenteric ischaemia, producing generalised abdominal rigidity and requiring emergency laparotomy.
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