Hinchey classification for diverticulitis

Background

  • Diverticulitis can present with range of severities and thus need for inpatient vs outpatient management

Classifications

Hinchey Classification[1]

  • Based on radiographic features
    • Stage 1a- phlegmon
    • Stage 1b- diverticulitis with pericolic or mesenteric abscess
    • Stage 2 - diverticulitis with walled off pelvic abscess
    • Stage 3 - diverticulitis with generalised purulent peritonitis
    • Stage 4 - diverticulitis with generalised faecal peritonitis

Modified Hinchey Classification[2]

  • 0 Mild clinical diverticulitis
  • Ia Confined pericolic inflammation or phlegmon
  • Ib Pericolic or mesocolic abscess
  • II Pelvic, distant intraabdominal, or retroperitoneal abscess
  • III Generalized purulent peritonitis
  • IV Generalized fecal peritonitis

See Also

References

  1. Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg. 1979;12: 85-109.
  2. Wasvary H, Turfah F, Kadro O, et al. Same hospitalization resection for acute diverticulitis. Am Surg. 1999;65:632–635.