Hinchey classification is used to describe perforations of the colon due to diverticulitis. Trends in the surgical management of diverticulitis. Stage 1b diverticulitis with pericolic or mesenteric abscess. Tsikitis oregon health and science university, portland, or, usa abstract sigmoid diverticulitis is an increasingly common western disease associated with a high morbidity and cost of treatment. Usually, the pain is severe and comes on suddenly, but it can also be mild and become worse over several days. E john hinchey 1934present, a general surgeon at the montreal general hospital and professor of surgery at mcgill university. Abstract colonic diverticular disease is a chronic disorder presenting with a variety of abdominal symptoms and recurrent episodes of acute diverticulitis. Diverticulitis can present with range of severities and thus need for inpatient vs outpatient management. Trends in the surgical management of diverticulitis nicole wieghard, cristina b.
These diverticulae are primarily pulsion type of pseudodiverticulae characterised by outpouching of mucosa. Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. This study was conducted to compare the benefits and disadvantages of different surgical treatments for hinchey iii or iv type of colon diverticulitis. A systematic search was conducted in medline, embase, cochrane central register of controlled trials, and the science citation index 1990. The sigmoid colon is the most common site to be involved. The management of complicated diverticulitis and the role of computed tomography. The most common symptom of diverticulitis is abdominal pain. Management of diverticulitis when a lareup diverticulitis occurs, your physician will most likely recommend an immediate transition to a restrictedibre or luid diet and physical rest, and is likely to prescribe antibiotics, possibly antispasmodics, and. Large abscesses c1 and perforated disease c4 are severe complications, but also massive diverticular c3 bleeding and total bowel obstruction c2 are entitled to acute interventions. The most common sign on examination is tenderness in the lower left side of the abdomen. Cirocchi r1, trastulli s, desiderio j, listorti c, boselli c, parisi a, noya g, liu l.