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.
|Published (Last):||17 June 2007|
|PDF File Size:||6.79 Mb|
|ePub File Size:||3.78 Mb|
|Price:||Free* [*Free Regsitration Required]|
Int J Colorectal Dis. This most widely used classification was actually based on an earlier clinical division of acute diverticulitis published by Hughes et al.
Please introduce links to this page from related articles ; try the Find link tool for suggestions. In cases of stenosis or recurrent rectal blood loss, it is advisable to perform a colonoscopy to rule out cancer. Diverticulosis the presence of bowel diverticula is an essentially ubiquitous phenomenon.
Advances in Surgery Its presentation may vary greatly per individual patient, from symptomatic diverticulosis to perforated diverticulitis. Moderate cases of diverticular disease, such as phlegmon or small abscesses, can be treated conservatively.
Since publication of the original Hinchey classification, several modifications and new grading systems have been developed. Furthermore, depending on the severity of the disease, the treatments for the various presentations of the disease will differ. 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.
Table 1 Hinchey classification and modified Hinchey classification by Sher et al.
Hinchey classification of acute diverticulitis | Radiology Reference Article |
I Pericolic phlegmon with small associated abscess. Table 2 Modified Hinhcey classification by Wasvary et al. Open in a separate window. Orphaned articles from February All orphaned articles. The planning of an elective operation makes it possible to do a proper preoperative work-up to prevent unwelcome surprises during surgery.
This review of the current classification systems for a condition as complex as diverticular disease raises the question: Since then diagnostic tools have widely been improved and new modalities have been developed.
KlarenbeekNiels de KorteDonald L. 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 original Hinchey classification for perforated diverticulitis and its modifications hincney mainly represented in stage C.
Hinchey Classification for Acute Diverticulitis
In this classification, complications are certified by severity and therapeutic options. Since then, several series have been published, but evidence from a randomized controlled trial is still to be awaited [ 30 ]. In the near future, the prescription of Mesalazine might be added to this preventive strategy.
Furthermore, a generalized peritonitis is only diagnosed by physical examination. Laparoscopic sigmoid resection for diverticulitis decreases major morbidity rates: These recommendations drawn up by the American Society of Colorectal Surgeons in have recently been challenged. Also, the role of elective or preventive sigmoid resection will be addressed. The wide spectrum of diverticular disease warrants a differentiated approach to the different manifestations.
There are several complications that can arise from diverticulitis, and one of the more serious complications of this is perforation of the bowel. Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author s and source are credited. Routine colonoscopy divulges the majority finds of asymptomatic diverticular disease.
Additionally, a difference was made between confined pericolic inflammation or phlegmon stage Ia and a confined pericolic abscess stage Ib.
This article reviews all current classifications for diverticular disease. Treatment of perforated diverticular disease of the colon. 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 ].