Hinchey's (Diverticulitis) Classification Review and it's Therapeutic Implacations

Abstract

Diverticular disease is an entity with high prevalence in western countries that increases with age, and affects approximately 80% of the population over 85 years of age. Acquired colonic diverticula are saccular mucosal and submucosal herniation (pseudodiverticles) and predominate in sigma, in western countries; the congenital ones possess the three parietal layers (true diverticula) and predominate in right side colon, in Asian countries. Approximately 10%-25% of patients with colonic diverticulosis, in their lifetime will present an episode of acute diverticulitis, which represents one of the most frequent causes of acute abdominal pain (3.8%). Clinically it express by abdominal pain in the left iliac fossa (exception in dolicosigma / right congenital diverticula) and may present complications such as phlegmon, abscesses, pylephlebitis, peritonitis, life threatening conditions. Computed tomography (CT) allows timely diagnosis, identification of complications and therapeutic planning. To this end, several classifications have been used, from which Hinchey's is the most renown (modified by Wasvary et al, Kaiser et al.), and other ones establish therapeutic correlation such as the one proposed by Sartelli et al. The objective of the present study is to make an iconographic review of this last one (Sartelli et al.) and to evaluate its therapeutic implications.