A 60-year-old man undergoes a CT scan for severe left iliac fossa pain and fever. It shows diverticulitis of the sigmoid colon with free fluid and bubbles in the mesentery, and a localized paracolic collection. According to the Hinchey classification of perforated diverticulitis, this corresponds to which stage?
- A Hinchey stage II
- B Hinchey stage I ✓
- C Hinchey stage III
- D Hinchey stage IV
Correct answer: B. Hinchey stage I
Explanation
Hinchey I is pericolic or mesenteric abscess with contained perforation, exactly what the CT shows. Hinchey II is a walled-off pelvic abscess, Hinchey III is generalized purulent peritonitis without fecal contamination, and Hinchey IV is fecal peritonitis. The presence of a confined paracolic collection without pelvic abscess or free pus places this patient firmly in stage I.
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.