Hinchey classification of acute diverticulitis
The original Hinchey classification was based on perioperative surgical finding. It has been later modified by Sher et al.:
Modified Hinchey classification (Sher et al., 1997):
| Stage | Description |
|---|---|
| I | Pericolic abscess |
| IIa | Distant abscess amendable to percutaneous drainage |
| IIb | Complex abscess associated with fistula |
| III | Generalized purulent peritonitis |
| IV | Fecal peritonitis |
Several modifications have been proposed to adapt Hinchey classification for CT findings, Sartelli et al. discriminated between uncomplicated disease and complicated disease stage Ia to 4
Sartelli et al.
Sartelli classification (Sartelli et al., 2015):
| Stage | Description |
|---|---|
| Uncomplicated disease | |
| Diverticula, thickening of the wall, increased density of the pericolic fat | |
| Complicated disease | |
| Ia | Pericolic air bubbles or little pericolic fluid without abscess |
| Ib | Abscess ≤4cm |
| IIa | Abscess >4cm |
| IIb | Distant air (>5cm from inflamed bowel segment) |
| III | Diffuse fluid without distant free air (no hole in colon) |
| IV | Diffuse fluid with distant free air (persistent hole in colon) |
References
Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg. 1978;12:85-109.
Sher ME, Agachan F, Bortul M. Laparoscopic surgery for diverticulitis. Surg Endosc. 1997;11:264–267.
Sartelli M, et al: A proposal for a CT driven classification of left colon acute diverticulitis. World J Emerg Surg 2015; 10: 3.
Updated 19/10/2018 13:10 by Lambert