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.
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Hinchey classification for diverticulitis
Hughes classification Hughes et al. Its presentation may vary greatly per individual patient, from symptomatic diverticulosis to perforated diverticulitis. These aspects make it probably the most useful classification in clinical practice; however, it has rarely been adopted in international literature.
III Small amounts of free air and fluid. Outcome after emergency surgery for acute perforated diverticulitis in cases.
Views Read Edit View history. Modified Hinchey classification by Wasvary et al. Laparoscopic surgery for diverticulitis. Diverticular disease of the sigmoid colon prevails in Western society. In recent years, magnetic resonance imaging MRI has gained popularity, because it lacks the ionizing radiation of a CT scan, yet matches its sensitivity and hinvhey [ 19 ]. Unlike diverticulosis the condition of having out-pouchingsdiverticulitis is not typically associated with active bleeding.
binchey Each classification accentuates different aspects of diverticular disease, creating its own strength and limitation. Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease: In the near future, the prescription of Mesalazine might be added to this preventive strategy.
The Hinchey classification – proposed by Hinchey et al.
By doing so, new imaging and treatment modalities are to be incorporated. According to current literature, a safe strategy might be to primarily perform a diagnostic laparoscopy. However, if it is not contained it leads to faecal contamination of the peritoneal cavity faecal peritonitis which is often fatal. KlarenbeekNiels de KorteDonald L. The surgical management of acute diverticulitis. The planning of an elective operation makes it possible to do a proper preoperative work-up to prevent unwelcome surprises during surgery.
Furthermore, conservative management of recurrent non-perforated diverticulitis is associated with low rates of morbidity and mortality. In this classification, complications are certified by severity and therapeutic options. McDermott FD et al. Its presentation among patients may vary from symptomatic diverticulosis to perforated diverticulitis. An individual approach, weighing symptoms and peri-operative risks on a case by case basis, seems the most appropriate policy [ 3435 ].
It is now thought that after a conservatively treated episode, diverticular disease usually follows a rather benign course and that complications occur mostly at first presentation [ 103233 ].
CT scan is of superior diagnostic value in case of stenosis or fistula.
Hinchey classification of acute diverticulitis | Radiology Reference Article |
Stage B disease forms indications for elective sigmoid resections, preferably laparoscopically. Recent studies have shown with anything up to a Hinchey III, a laparoscopic wash-out is a safe procedure,  avoiding the need for a laparotomy and stoma formation. 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.
A more hazardous course has been suggested. The wide use of Divergiculitis scans initiated modifications to the Hinchey classification, but also several new radiological classifications for divefticulitis disease were developed. CT scan images resembling the four Hughes stages.
Classifications A proper classification system can improve mutual communication between doctors of different specialties and support clinical decision making. Given a useful classification system ought to guide clinical decision making and management, this review serves to combine the available classifications with current knowledge of practice into diverticuliti more useful practice parameter for treating diverticular disease.
With the clinical history, physical examination and a CT scan of the abdomen the situation of the patient can be assessed and the surgeon is able to choose the best course of treatment. A second analysis using manual cross reference search of the bibliographies of relevant articles located studies not found in the first search.
Additionally, a difference was made between confined pericolic inflammation or phlegmon stage Ia and diverticultis confined pericolic abscess stage Ib. The publications on the role of CT scans in diverticular disease by Ambrosetti hnichey al. Despite modifications proposed by multiple authors, the traditional classification is still widely used.
Methods An extensive literature analysis was performed using the PubMed database.