What is the Hinchey classification for this patient?
| Modified Hinchey classification | |
|---|---|
| Ib | Confined pericolic abscess |
| II | Pelvic, intrabdominal or retrocolic abscess |
| III | Generalized purulent peritonitis |
| IV | Faecal peritonitis |
What is Hinchey 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 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 laparoscopic peritoneal lavage?
Laparoscopic peritoneal lavage should be considered an effective and safe option for the treatment of patients with sigmoid diverticulitis with Hinchey stage III peritonitis; it can also be consider as a “bridge” surgical step combined with a delayed and elective laparoscopic sigmoidectomy in order to avoid a Hartmann …
How many stages of diverticulitis are there?
Based on these factors, a five-grade staging was created as follows: Stage 1, uncomplicated diverticulitis; Stage 2, complicated diverticulitis with small abscess (<6 cm); Stage 3, complicated diverticulitis with large abscess (≥6 cm) or distant intraperitoneal or retroperitoneal air; Stage 4, Generalized peritonitis …
How many types of diverticulitis are there?
Diverticular disease grows more common with age. About 10% of people over age 40 will get diverticulosis, and 50% will get it after age 60. It affects nearly everyone over 80. There are two main types of diverticular disease — diverticulitis and diverticular bleeding.
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:
Which is the most commonly used classification for diverticular disease?
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.
Are there 2 types of diverticulitis?
What are the three stages of diverticulitis?
Table 1
| Hinchey classification | Modified Hinchey classification | |
|---|---|---|
| Stage I | Pericolic abscess or phlegmon | Stage Ib |
| Stage II | Pelvic, intra‐abdominal, or retroperitoneal abscess | Stage II |
| Stage III | Generalized purulent peritonitis | Stage III |
| Stage IV | Generalized fecal peritonitis | Stage IV |
What type of bacteria is diverticulitis?
The infection in diverticulitis results from normal colonic flora released into the peritoneal cavity through a colonic perforation. This is, therefore, a polymicrobial infection. The most common organisms cultured include anaerobes, such as Bacteroides fragilis, and gram negatives, such as Escherichia coli.
How many types of laparoscopy are there?
There are two types of laparoscope: a telescopic rod lens system, usually connected to a video camera (single-chip or three-chip) a digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system.
What type of surgeon performs laparoscopy?
Who performs laparoscopy? The following specialists perform laparoscopy: General surgeons and pediatric surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.
When is surgery needed for perforated diverticulitis?
Most experience symptom resolution within 2-3 days. A CT scan should be considered for persistent or worsening symptoms to assess for the presence of worsening inflammation or an abscess. Surgery should be considered for patients with worsening symptoms, or with no symptomatic improvement in 3-4 days.
Does perforated diverticulitis always require surgery?
Surgery usually isn’t necessary in people who have acute diverticulitis. But there are exceptions: If abscesses (collections of pus) have formed, and treatment with antibiotics isn’t successful, surgery is unavoidable.
What peritonitis means?
Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection.
What antibiotic is used for diverticulitis?
If antibiotics are given for uncomplicated diverticulitis, consider amoxicillin/clavulanic acid or an oral cephalosporin plus metronidazole if the patient can take oral therapy. If intravenous therapy is needed cefazolin, cefuroxime, or ceftriaxone, all plus metronidazole or ampicillin/sulbactam alone can be used.
What’s the difference between laparoscopic and laparoscopy?
Laparoscopy is a procedure to look inside your tummy (abdomen) by using a laparoscope. A laparoscope is like a thin telescope with a light source. It is used to light up and magnify the structures inside the abdomen. A laparoscope is passed into the abdomen through a small cut in the skin.
What is Hinchey III peritonitis?
Hinchey III – purulent peritonitis (the presence of pus in the abdominal cavity) Hinchey IV – feculent peritonitis. (Intestinal perforation allowing feces into abdominal cavity). The Hinchey classification is useful as it guides surgeons as to how conservative they can be in emergency surgery.
What is the classification of peritonitis?
The classification is I–IV: Hinchey III – purulent peritonitis (the presence of pus in the abdominal cavity) Hinchey IV – feculent peritonitis. (Intestinal perforation allowing feces into abdominal cavity).
What is the Hinchey Classification of diverticulitis?
The Hinchey classification for acute diverticulitis (anywhere along the bowel, not just the colon) has been variously adapted and modified since its original description, and is useful not only in academia but also in outlining successive stages
What is Hinchey Classification of colonic perforation?
The Hinchey classification – proposed by Hinchey et al. in 1978 classifies a colonic perforation due to diverticular disease. The classification is I–IV: Hinchey III – purulent peritonitis (the presence of pus in the abdominal cavity)