What is the Hinchey classification used for?
The Hinchey classification has traditionally been used in international literature to distinguish four stages of perforated disease (see Table 1). This most widely used classification was actually based on an earlier clinical division of acute diverticulitis published by Hughes et al. (see Fig.
What is Hinchey classification of diverticulitis?
The universally accepted is the Hinchey classification[8], which descriptively characterises the various stages of diverticulitis and its acute complications. Type I and Type II refer to inflammatory phlegmon and paracolic abscesses while type III and IV refer to purulent and faeculent peritonitis respectively.
How do you classify diverticulitis?
Classification
- stage 0: clinical: mild clinical diverticulitis.
- stage Ia: clinical: confined pericolic inflammation or phlegmon.
- stage Ib: clinical: pericolic or mesocolic abscess.
- stage II: clinical: pelvic, distant intra-abdominal or retroperitoneal abscess.
- stage III: clinical: generalized purulent peritonitis.
- stage IV:
What is the basis of the Hinchey classification staging system for perforated diverticulitis?
Clinical staging by Hinchey’s classification is based on computed tomography findings and directed toward selection of the proper surgical procedure when diverticulitis is complicated, as follows: Stage I disease: Phlegmon or localized pericolic or mesenteric abscess.
What is Hinchey II diverticulitis?
C Hinchey II diverticulitis is characterized by the presence of a pelvic or inter-loop abscess, or by the presence of an abscess that is larger than 4 cm. D Hinchey III and E Hinchey IV diverticulitis are characterized by the presence of purulent peritonitis and feculent peritonitis, respectively.
What is the difference between complicated and uncomplicated diverticulitis?
Diverticulitis can be categorized into uncomplicated and complicated disease. Uncomplicated diverticulitis involves thickening of the colon wall and peri-colonic inflammatory changes. Complicated diverticulitis additionally includes the presence of abscess, peritonitis, obstruction, and/or fistula.
Are there 2 types of diverticulitis?
Two kinds of acquired diverticular disease were identified. The more common variety presented with pain, bowel symptoms or fistulae, and the less common with bleeding.
What are the three stages of diverticulitis?
Stages of Diverticulitis
- Stage I: Diverticulitis with phlegmon or localized pericolic or mesenteric abscess.
- Stage II: Diverticulitis with walled-off pelvic, intra-abdominal, or retroperitoneal abscess.
- Stage III: Perforated diverticulitis causing generalized purulent peritonitis.
What’s the difference between diverticulitis and diverticulosis?
Diverticulosis occurs when small, bulging pouches (diverticula) develop in your digestive tract. When one or more of these pouches become inflamed or infected, the condition is called diverticulitis.
What is the first line treatment for diverticulitis?
Antibiotic therapy aimed at anaerobes and gram-negative rods is first-line treatment for diverticulitis. Whether treatment is administered on an inpatient or out-patient basis is determined by the clinical status of the patient and his or her ability to tolerate oral intake.
How serious is complicated diverticulitis?
The mortality rate in uncomplicated diverticulitis is negligible with appropriate conservative therapy. Complicated diverticulitis requiring surgery may lead to death in approximately 5% of patients. Perforation of the bowel with resulting peritonitis increases the risk of death to 20%.
What is the main cause of diverticulitis?
Doctors believe the main cause is a low-fiber diet. Most people with diverticulosis don’t have symptoms. Sometimes it causes mild cramps, bloating or constipation. Diverticulosis is often found through tests ordered for something else.
What triggers your diverticulitis?
Diverticulitis is caused by an infection of one or more of the diverticula. It is thought an infection develops when a hard piece of stool or undigested food gets trapped in one of the pouches. This gives bacteria in the stool the chance to multiply and spread, triggering an infection.
What’s worse diverticulitis or diverticulitis?
Diverticulitis: If infection occurs, the condition is called diverticulitis. Diverticulitis is more serious because infection can lead to other problems. Diverticulosis leads to diverticulitis in about 1 out of 5 to 1 out of 7 cases.
What is the main cause of diverticulosis?
What is the most common treatment for diverticulitis?
Your doctor is likely to recommend: Antibiotics to treat infection, although new guidelines state that in very mild cases, they may not be needed. A liquid diet for a few days while your bowel heals. Once your symptoms improve, you can gradually add solid food to your diet.
What is the best medication for diverticulitis?
How is diverticulitis treated? If your diverticulitis is mild, your healthcare provider will prescribe an oral antibiotic, such as metronidazole (Flagyl®), trimethoprim-sulfamethoxazole (Bactrim®), ciprofloxacin (Cipro®) or amoxicillin and clavulanic acid (Augmentin®).
What is the number one cause of diverticulitis?
Can you live a long life with diverticulitis?
The vast majority of patients would live their whole lives without having any sort of complication. The reason to be concerned is that there is a risk for complications, and there are ways that we reduce those complications: Increase your dietary fiber. Reducing obesity.
What foods trigger diverticulitis?
Actually, no specific foods are known to trigger diverticulitis attacks. And no special diet has been proved to prevent attacks. In the past, people with small pouches (diverticula) in the lining of the colon were told to avoid nuts, seeds and popcorn.
What is the best treatment for diverticulosis?
Diverticulosis is common, doesn’t cause symptoms or need treatment. Mild diverticulitis is treated with antibiotics. Surgery is needed if problems develop. A high fiber diet, exercise and drinking lots of water can help prevent.
What is the best drink for diverticulitis?
Water and clear juices (such as apple, cranberry, or grape), strained citrus juices or fruit punch. Coffee or tea (without cream or milk) Clear sports drinks or soft drinks, such as ginger ale, lemon-lime soda, or club soda (no cola or root beer) Clear broth, bouillon, or consommé
What should you avoid eating with diverticulitis?
Foods to avoid with diverticulitis include high-fiber options such as:
- Whole grains.
- Fruits and vegetables with the skin and seeds.
- Nuts and seeds.
- Beans.
- Popcorn.
What triggers diverticulitis flare ups?
You’re more likely to experience a diverticulitis flare-up if you are:
- Over age 40.
- Overweight or obese.
- A smoker.
- Physically inactive.
- Someone whose diet is high in animal products and low in fiber (most Americans)
- Someone who takes non-steroidal anti-inflammatory drugs (NSAIDs), steroids or opioids.