A 60-year-old man presents with left iliac fossa pain, fever, and tachycardia. CT shows sigmoid diverticulitis with a localized pericolic abscess. According to the Hinchey classification, this corresponds to which stage?
- A Stage II
- B Stage Ib
- C Stage Ia ✓
- D Stage III
Correct answer: C. Stage Ia
Explanation
The Hinchey classification grades the severity of complicated diverticulitis: stage Ia is a pericolic abscess, stage Ib is a pelvic or distant abscess, stage II is generalized purulent peritonitis, and stage III is generalized feculent peritonitis. C localized pericolic collection therefore fits stage Ia. The key distractor is stage Ib, which requires an abscess extending beyond the mesocolon into the pelvis, not one confined to the pericolic tissue.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
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