Antibiotics have been the mainstay of therapy for most patients with Patients with clinically mild diverticulitis, typically with Hinchey stage 0. Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of. Introduction: Acute diverticulitis (AD) is increasingly seen in Emergency services. The application of a reliable classification is vital for its safe and effective management. The Hinchey system is a surgical classification and as such it is not.

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J Trauma Acute Care Surg ; Yet, new insights in the natural history of the disease, the emergence of the computed tomography scan, and new treatment modalities diverficulitis for evolving classifications.

Material and methods Prospective, observational study using a database including all consecutive patients attending our hospital’s ER who were diagnosed with AD after their visit. Long-term treatment with mesalazine and rifaximin versus rifaximin alone for patients with recurrent attacks of acute diverticulitis of colon.

Methods An extensive literature analysis was performed using the Diverficulitis database. Its treatment requires accurate diagnosis and clear staging criteria. Other factors unrelated to the application of the protocol were not considered.

Review of current classifications for diverticular disease and a translation into clinical practice

Collins D, Winter DC. Clinical episodes are characterized by focus on divertkculitis objective signs, like raised infectious parameters in laboratory tests and typical findings on CT scan or colonoscopy [ 1 ].


We thank diverticuulitis staff of the General Surgery Service who made it possible to apply the AD management protocol at our center, the staff at the Radiology Service for their help in implementing the mNeff classification, and the Home Hospitalization team.

Each classification accentuates different aspects of diverticular disease, creating its own strength and limitation. Grade II 30, 5.

Review of current classifications for diverticular disease and a translation into clinical practice

Stage B disease forms indications for elective sigmoid resections, preferably laparoscopically. This modification also implied the use of new treatment strategies, such as CT-guided percutaneous drainage of abscesses.

Hospital Universitari Parc Tauli. Indications for operation and predictive parameters of early and late medical treatment failure: National Center for Biotechnology InformationU. Early elective surgery of acute diverticulitis of the colon. Of these, out of In conclusion, this manuscript provides an overview of current classification systems for diverticular disease.

A comparative cohort study. Computed tomography in acute left colonic diverticulitis. Cochrane Database Syst Rev ;11 The experience we have accumulated with this protocol over a 6-year period at our center suggests that AD can be managed safely.

A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department. Patients may have serious complaints, but interventions can usually be postponed to an elective setting. A three-stage model is advanced for a renewed and comprehensive classification system for diverticular disease, incorporating up-to-date imaging and treatment modalities. The planning of an elective operation makes it possible to do a proper preoperative work-up to prevent unwelcome surprises during surgery.

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The combination of the following symptoms should be suspected: Outpatient versus hospitalization management for uncomplicated diverticulitis: In this study we describe our experience with the application of a management protocol for AD which uses the mNeff radiological classification in combination with clinical criteria of comorbidity and SIRS, in order to be able to apply the most appropriate treatment in each case.

Is colonoscopy still mandatory after a CT diagnosis of left-sided diverticulitis: Challenging a classic myth: Grade IV 34, 5. These new insights resulted in a more individualized and conservative approach to mild diverticular disease, making the extent of subjective complaints even more important [ 212 ].

At our service, after radiological diagnosis, the type of AD is graded using the mNeff classification Table I. If the perforation is diverticulutis small, it may be contained often referred to by surgeons as a localized perforation.

Application of a modified Neff classification to patients with uncomplicated diverticulitis. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis.

Hinchey Classification

Treatment for complicated AD varies from antibiotic use only to resective surgery of hindhey inflamed area in case of peritonitis or pneumoperitoneum Categorical variables are described in absolute numbers and percentages. Support Center Support Center. Int J Colorectal Dis ;25 Meta-analysis of test accuracy.