Type:
Educational Exhibit
Keywords:
Abdomen, CT, Surgery, Diverticula
Authors:
J. McGill, G. Mitreski, N. Kutaiba; Heidelberg, VIC/AU
DOI:
10.26044/ranzcr2021/R-0060
Imaging findings OR Procedure details
Key imaging findings in diverticulitis
1. Uncomplicated diverticulitis
2 . Common complications:
- local perforation
- fluid collection
3. Uncommon complications:
- diffuse free abdominal fluid
- fistula formation
Imaging scoring systems
A number of different scoring algorithms have been proposed with some of the most recently published including the modified Hinchey, modified Neff, World Society of Emergency Surgery (WSES) and modified Siewert scoring systems. [2-5]
Hinchey classification
The Hinchey classification, originally a surgical classification system, was first described in 1978 and was subsequently adapted for use in CT interpretation by Kaiser et al. in 2005.[6] It has been the most widely accepted system [7] with disease classified into stages 1-4 based on severity.[2]
Modified Neff
The modified Neff system categorises disease as ranging from uncomplicated (stage 0) to pneumoperitoneum with free liquid (stage 4).[3]
WSES
More recently the WSES working group guidelines described a new CT based classification for acute left sided colonic diverticulitis.[4]
Modified Siewert
The Modified Siewert algorithm is similar with gradings 1-4 based on the presence of complications including free air and abscess.[5]