Which statement correctly describes Hinchey stage III perforated diverticulitis?

• A Generalised purulent peritonitis without gross faecal contamination ✓
• B Pelvic abscess amenable to image guided drainage
• C Pericolic abscess confined to the mesentery of the sigmoid colon
• D Generalised faecal peritonitis from a freely perforated diverticulum

Explanation

The modified Hinchey classification grades the severity of perforated diverticulitis: stage Ia is a pericolic abscess, Ib a pelvic abscess, stage II a distant intra-abdominal abscess, stage III generalised purulent peritonitis, and stage IV generalised faecal peritonitis. Stage III therefore denotes pus without gross faecal soiling, typically managed with lavage or resection depending on stability. The key distractor is stage IV, where actual faeces contaminate the peritoneal cavity and mortality is highest.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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