Hinchey classification of acute diverticulitis
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Classification
- stage 0:
- clinical: mild clinical diverticulitis
- CT finding: diverticula with colonic wall thickening
- stage Ia:
- clinical: confined pericolic inflammation or phlegmon
- CT finding: pericolic soft tissue changes
- stage Ib:
- clinical: pericolic or mesocolic abscess
- CT finding: Ia changes and pericolic or mesocolic abscess
- stage II:
- clinical: pelvic, distant intra-abdominal or retroperitoneal abscess
- CT finding: Ia changes and distant abscess, usually deep pelvic
- stage III:
- clinical: generalized purulent peritonitis
- CT finding: localized or generalized ascites, pneumoperitoneum, peritoneal thickening
- stage IV:
- clinical: generalized fecal peritonitis
- CT finding: same as stage III
Clinical use
In general, abscesses in stage Ib and II may be drained by interventional radiology, and stage III and IV disease is managed with emergent surgery.
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