Antibiotics have been the mainstay of therapy for most patients with Patients with clinically mild diverticulitis, typically with Hinchey stage 0. Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of. Introduction: Acute diverticulitis (AD) is increasingly seen in Emergency services. The application of a reliable classification is vital for its safe and effective management. The Hinchey system is a surgical classification and as such it is not.

Author: Kagagis Malahn
Country: Libya
Language: English (Spanish)
Genre: Politics
Published (Last): 20 August 2007
Pages: 461
PDF File Size: 13.33 Mb
ePub File Size: 1.73 Mb
ISBN: 402-5-66852-225-3
Downloads: 72579
Price: Free* [*Free Regsitration Required]
Uploader: Vudotilar

Antibiotics for uncomplicated diverticulitis. Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis. Diverticular disease of the sigmoid colon prevails in Western society.

Hinchey classification of acute diverticulitis | Radiology Reference Article |

Acute left colonic diverticulitis – Compared performance of computed tomography and water-soluble contrast clasificaion CT findings by Ambrosetti et al. In the case of a purulent peritonitis, either laparoscopic sigmoid resection with primary anastomosis with or without defunctioning stoma or even laparoscopic lavage may be considered in selected cases.

Treatment of acute diverticulitis laparoscopic lavage vs.

Stage B includes non-acute complications of diverticular disease, such as symptomatic stenosis, fistulas to hollow organ, recurrent self-limiting diverticular bleeding, and incapacitating complaints. In conclusion, this manuscript provides an overview of current classification systems for diverticular disease. Of the grade A patients, patients required admission as a result of comorbidity or SIRS 32oral intolerance or pain or after re-consultation at the ER Massive diverticular bleeding might be approached endoscopically clipping, coagulation, or adrenaline injections or even endovascular coilingbut in most centers, a laparoscopic sigmoid resection is probably the final resolution.


The combination of the following symptoms should be suspected: Br J Surg ;99 4: A prematurely terminated randomized controlled trial. Table 6 Proposed classification.

Outcomes of percutaneous drainage without surgery for patients with diverticular abscess.

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

Diverticulitis, Diverticular disease, Classification. Of the 52 AD stage Ia patients 8.

Grade IV 34, 5. New trends in the management of diverticulitis and colonic diverticular disease. Dig Surg ;30 Challenging a classic myth: The original Hinchey classification for perforated diverticulitis and its modifications are mainly represented in stage C. Diverticular disease of the colon.

Prospective evaluation of the value of magnetic resonance imaging in suspected acute sigmoid diverticulitis. Since the mids, laparoscopic sigmoid resections for diverticular disease have diverticulitid popularity.

Hinchey Classification – Wikipedia

Prognostic factors in perforating diverticulitis of the large intestine. After a first attack, preventive measures have to be taken into account, such as high-fiber diet, weight loss, and treatment of comorbid conditions.


Radiol Clin North Am ; Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis. Acknowledgements We thank the staff of the General Surgery Service who made it possible to apply the AD management protocol at our center, the staff at the Radiology Service for their help in implementing the mNeff classification, and the Home Hospitalization team.


Grade Ib patients receive medical treatment. The clinical applicability of this three-stage model has yet to be addressed viverticulitis means of prospective data and expert panel validation.

The remaining patients evolved satisfactorily with antibiotic treatment. Grade IV patients require surgical treatment in most cases, but always depending on their hemodynamic and clinical status. Proposal for a clinical scoring system. New physiopathological and therapeutic approaches to diverticular disease of the colon.