Update on the management of sigmoid diverticulitis

Table 3 Hinchey classification and modified Hinchey classification of acute diverticulitis

Hinchey classification[66]		Modified Hinchey classification[60,69,91] (imaging- or surgery-defined)		Comment
I	Pericolic abscess or phlegmon	0	Mild clinical diverticulitis	LLQ pain, elevated WBC, fever, no confirmation by imaging or surgery
		I	Confined pericolic inflammation: Phlegmon
		I	Confined pericolic abscess	In immediate adjacency to inflamed bowel segment
II	Pelvic, intra-abdominal or retroperitoneal abscess	II	Pelvic, distant intra-abdominal, or retroperitoneal abscess
III	Generalized purulent peritonitis	III	Generalized purulent peritonitis	No open communication with bowel lumen (ruptured abscess)
IV	Generalized fecal peritonitis	IV	Fecal peritonitis	Free perforation, open communication with bowel lumen
		SMOL1	Smoldering diverticulitis/peridiverticulitis	Recurrent/intermittent or chronic
		FIST2	Colovesical/vaginal/enteric/cutaneous fistula	Chronic or acute
		OBST3	Large and/or small bowel obstruction	Chronic or acute

¹Smoldering.

²Fistula formation.

³Obstruction. LLQ: Left lower quadrant; WBC: White blood cell.