According to the Hinchey classification of perforated diverticulitis, which stage corresponds to generalized purulent peritonitis?

• A Stage I
• B Stage II
• C Stage IV
• D Stage III ✓

Explanation

Hinchey stage I is a pericolic abscess, stage II is a pelvic or distant abscess contained by adjacent structures, stage III is generalized purulent peritonitis from a sealed-off microscopic perforation, and stage IV is feculent peritonitis from a free communication with the bowel lumen. The distinction matters because stage III has pus without fecal contamination, which carries a better prognosis than stage IV fecal peritonitis.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.