Welcome to Classifications and Online Calculators in Radiology

This site was build along with the Atlas of Radiology Images to support your knowledge in radiology.

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that are used in radiology and related fields with free access.

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    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
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