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Hinchey Classification is used to describe perforations of the colon due to diverticulitis. The classification was developed by Dr. E John Hinchey (1934–present), a general surgeon at the Montreal General Hospital and professor of surgery at McGill University. Diverticulosis (the presence of bowel diverticula) is an essentially ubiquitous ...
a. Localized or generalized peritonitis caused by perforation of the bowel secondary to the cancer b. Viable but injured proximal bowel that, in the opinion of the operating surgeon, precludes safe anastomosis c. Complicated diverticulitis [2] Use of the Hartmann's procedure initially had a mortality rate of 8.8%. [3]
Perforated diverticulitis often requires surgery due to risks of infection or recurrence. Recurrent diverticulitis may required resection even in the absence of perforation. Bowel resection or repair is typically initiated earlier in patients with signs of infection, the elderly, immunocompromised, and those with severe comorbidities.
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset. [1] Patients commonly have elevated C-reactive protein and a high white blood cell count. [10] In Asia it is usually on the right (ascending colon), while in North America and Europe, the abdominal pain is usually on the left lower side (sigmoid colon).
That contradicts the prevailing thinking that 10% to 25% of people with diverticulosis go on to develop diverticulitis. Tears in the colon leading to bleeding or perforations may occur; intestinal obstruction may occur (constipation or diarrhea does not rule this possibility out); and peritonitis, abscess formation, retroperitoneal fibrosis ...
Trauma, following colonoscopy, bowel obstruction, colon cancer, diverticulitis, stomach ulcers, ischemic bowel, C. difficile infection [2] Diagnostic method: CT scan, plain X-ray [2] Treatment: Emergency surgery in the form of an exploratory laparotomy [2] Medication: Intravenous fluids, antibiotics [2]
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Complicated acute diverticulitis is distinguished from uncomplicated diverticulitis by the presence of abscess or colonic perforation. Chronic smoldering diverticulitis is caused by recurrent acute diverticulitis that does not respond to medical treatment but does not progress to complications such as abscess, peritonitis, enteric fistula, or ...