A CT scan of a 58-year-old woman with acute diverticulitis shows a 5 cm thick-walled pericolic abscess adjacent to the sigmoid colon. According to the Hinchey classification, this finding corresponds to which stage?

• A Stage Ia ✓
• B Stage Ib
• C Stage II
• D Stage III

Explanation

Hinchey stage is based on the extent of contamination: stage Ia is a confined pericolic abscess, Ib is a pelvic abscess, stage II is a distant abscess (pelvis, subphrenic space) amenable to percutaneous drainage, stage III is generalised purulent peritonitis and stage IV is faecal peritonitis. The distractor B tempts students who confuse any pelvic collection with a pericolic one; here the abscess lies directly beside the inflamed sigmoid segment, which defines Ia.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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