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Laparoscopic Sigmoid Colectomy for Diverticulitis
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Paul Trinity Stephen, Rohin Mittal
Complicated diverticular disease may be treated by radiological drainage, laparoscopy or laparotomy, with or without sigmoid resection, depending on the presentation. The Hinchey classification [11] (Table 13.1) is useful to classify and stage acute complicated diverticulitis, and aids in developing management strategies.
Colorectal Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Jennie Grainger, Samson Tou, Steve Schlichtemeier, William Speake, Fung Joon Foo, Frank McDermott
How do you classify perforated diverticulitis?Hinchey classification: Stage 1, pericolic abscessStage 2, pelvic abscessStage 3, generalised purulent peritonitisStage 4, fecal peritonitis
Acute Diverticulitis
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
The Hinchey classification, which was first described in a 1978 publication, has remained the primary method of characterizing the severity of acute diverticulitis, despite multiple alternate classification schemes that have been developed over the years. The simplicity of this classification system has led to its enduring legacy (Hinchey et al., 1978).
Incidence of acute diverticulitis compared to appendicitis in emergency wards: a 10-year nationwide register and cohort study from Finland
Published in Scandinavian Journal of Gastroenterology, 2023
Roni Saren, Sami Aspegren, Hannu Paajanen, Mika Ukkonen, Pirjo Käkelä
Operative and conservative treatments of AD (n = 614) are compared in Table 2. The patients undergoing emergency surgery for AD were older, male and had more serious infection in the Hinchey classification than the patients treated conservatively. Complication rates of treatment (Clavien-Dindo classification) were also higher in the surgical group. Mortality rates were similar between the surgically and conservatively treated groups (8.0% versus 11.5%). Eight patients in the conservative group died because of perforated peritonitis (Clavien-Dindo Gr V). The outcomes of AD patients in three age groups (<50, 50–70, and >70 years old) are compared in Table 3. Emergency operations were performed more frequently in patients aged >70 years. Complications of treatment (Clavien-Dindo) and overall and disease-specific mortality were also higher in older patients with AD compared to the patients aged <50 years. Disease-specific mortality increased from 0% to 5.7% along with increasing patient age when comparing the age groups <50 years and >70 years.
Development and validation of a diagnostic prediction model distinguishing complicated from uncomplicated diverticulitis
Published in Scandinavian Journal of Gastroenterology, 2018
Hendrike E. Bolkenstein, Bryan Jm van de Wall, Esther Cj Consten, Job van der Palen, Ivo Amj Broeders, Werner A. Draaisma
A total of 1514 consecutive patients presented to the emergency department between January 2005 and January 2017 with a clinically suspected episode of diverticulitis. Of these, 572 patients were excluded as they underwent sonography only (n = 476), or they had no radiological examination at all (n = 96). A total of 942 patients were included of whom 171 (18%) had CD and 771 (82%) had UD. The dataset was randomly split into a derivation and validation set. The validation dataset contained 467 patients of whom 90 (19%) had CD. The derivation dataset contained 475 patients of whom 82 (18%) patients had CD. The Hinchey classification of the complicated cases in the derivation dataset was as follows: 37 (8%) Hinchey IB, 17 (4%) Hinchey II, 23 (5%) Hinchey III and 5 (1%) Hinchey IV. Of the uncomplicated cases, 250 (64%) patients were treated as in inpatients and 99 (26%) patients received antibiotics. Of the complicated cases, 76 (93%) patients were treated as in-inpatients and 65 (79%) patients received antibiotics. Complicated cases that did not receive antibiotics were all Hinchey IB patients. Patient characteristics are shown in Table 1.