The modified Hinchey classification is based on CT scan findings and is used to categorize diverticulitis, as well as help to guide appropriate. The modified Hinchey classification is based on computed tomography scan findings and is used to categorize diverticulitis, as well as help to guide appropriate. Clinical staging by Hinchey’s classification is based on computed tomography findings and directed toward selection of the proper surgical procedure when.

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Acute left colonic diverticulitis—compared performance of computed tomography and water-soluble contrast enema: Obesity increases the risks of diverticulitis and diverticular bleeding.

When a general peritonitis is suspected on physical examination, confirmed by CT scan, surgical intervention is warranted. KlarenbeekNiels de KorteDonald L. Methods An extensive literature diverticulitiss was performed using the PubMed database. Can superselective embolization be definitive for colonic diverticular hemorrhage? The original Hinchey classification was based on both clinical and surgical findings.

Hinchey classification for diverticulitis

Methods This article reviews all current classifications for diverticular disease. Such complaints are considered to be self-limiting, sometimes assisted by antibiotic therapy. McDermott FD et al. A prospective study of dietary fiber types and symptomatic diverticular disease in men. A second analysis using manual cross reference search of the bibliographies of relevant articles located studies not found in the first search.

Hinchey Classification is used to describe perforations of the colon due to diverticulitis. Introduction Diverticular disease of the sigmoid colon is a common condition in Western society.

Hinchey classification for diverticulitis – WikEM

This last group of patients covers mainly those young patients who are incapacitated by recurrent attacks and hospital admissions, which prevent them from having normal working careers and social life. Retrieved from ” https: The pouches diverticula occur where diverticuiltis is a gap between or weakness within the muscle fibres of the bowel wall, classically at sites of vessel protrusion into the wall. Early elective surgery of acute diverticulitis of the colon. The current classifications of diverticular disease are based on clinical, radiological, or operative findings, yet most lack a translation into daily clinical practice.


Newer insights into the pathophysiology of diverticular disease, comparable to inflammatory bowel disease, have led to research on the potentials of 5-aminosalicylic acid Mesalazine and probiotics as adjunctive treatments for diverticular disease.

CT scan images resembling the four Hughes stages. Hlnchey, a generalized peritonitis is only diagnosed by physical examination. Elective surgery after acute diverticulitis.

Preventive measures are thought to be more successful by several authors, high-fiber diet, and prevention of obesity and treatment of comorbidities are the usual ingredients [ 22 — 24 ]. Moreover, none of the classifications seem to sufficiently embrace the entire spectrum of the disease. Indications for elective sigmoid resection in diverticular disease.

Hinchey Classification for Acute Diverticulitis – Doctor Guidelines

Is there a need for another ninchey InMyers et al. Practice parameters for the treatment of sigmoid diverticulitis—supporting documentation.

Therefore, elective sigmoid resections should be restricted for use in treating complicated disease, such as symptomatic stenosis, fistulas to a hollow organ, or recurrent diverticular bleeding. Clinical episodes are characterized by focus on more objective signs, like raised infectious parameters in laboratory tests and typical findings on CT scan or colonoscopy [ 1 ].

In another modification, the Stage II has been divided into IIa abscesses amenable to percutaneous drainage and IIb complex abscess with or without fistula in later modifications. The management of complicated diverticulitis and the role of computed tomography.

CT scan is of superior diagnostic value in case of stenosis or fistula. Pelvic abscess — Risk of death: Advances in Surgery Result A three-stage model is advanced dievrticulitis a renewed and comprehensive classification system for diverticular disease, incorporating up-to-date imaging and treatment modalities.


Phlegmon or localized abscess pericolic or mesenteric — Risk of death: Published online Sep Diverticular disease of the sigmoid colon prevails in Western society. Stage B disease forms indications for elective sigmoid resections, preferably laparoscopically.

Collins D, Winter DC. An individual approach, weighing symptoms and peri-operative risks on a case by case basis, seems the most appropriate policy [ 3435 ]. Table 2 Modified Hinchey classification by Wasvary et al.

Review of current classifications for diverticular disease and a translation into clinical practice

Its presentation among patients may vary from symptomatic diverticulosis to perforated diverticulitis. Furthermore, recent publications on the natural course of diverticular disease suggest applying early elective sigmoid resection in high-risk patients, such as the use of immune divetriculitis therapy, having chronic renal failure, or collagen—vascular diseases.

Hinchey classification [ 3 ] Modified Hinchey classification by Sher et al. Recent studies have shown with anything up to a Hinchey III, a laparoscopic wash-out is a safe procedure, [3] avoiding the need diverhiculitis a laparotomy and stoma formation. The Standards Task Force. If the perforation is very small, it may be contained often referred to by surgeons as a localized perforation.

Treatment of perforated diverticular disease of the colon. Free gas associated with localized or generalized ascites and possible peritoneal wall thickening. Diverticulosis the presence of bowel diverticula is an essentially ubiquitous phenomenon. The wide spectrum of diverticular disease warrants a differentiated approach to the different manifestations.