Current indications and role of surgery in the management of sigmoid diverticulitis

Table 1 Hinchey classification and its modifications

	Original Hinchey classification	Sher[10], Kohler modification[11]	Wasvary modification[33]	Kaiser modification[71]1
Stage I	Pericolic abscess confined by the mesentery of the colon	Pericolic abscess	Ia phlegmon	Ia confined pericolic inflammation-phlegmon
			Ib pericolic abscess	Ib confined pericolic abscess
Stage II	Pelvic abscess resulting from a local perforation of a pericolic abscess	IIA distant abscess amenable to percutaneous drainage	Pelvic abscess	Pelvic, distant intrabdominal or retroperitoneal abscess
		IIB complex abscess associated with/without fistula
Stage III	Generalized peritonitis resulting from rupture of pericolic/pelvic abscess into the general peritoneal cavity	Generalized purulent peritonitis	Purulent peritonitis	Generalized purulent peritonitis
Stage IV	Fecal peritonitis results from the free perforation of a diverticulum	Fecal peritonitis	Fecal peritonitis	Fecal peritonitis

¹This modification also includes stage 0, defined as mild clinical diverticulitis.

Table 2 Ambrosetti classification[12]

Moderate diverticulitis	Severe diverticulitis
Localized sigmoid wall thickening (> 5 mm)	Same as mild diverticulitis plus one of the following:
Inflammation of pericolic fat	Abscess
	Extraluminal air
	Extraluminal contrast