Diverticulitis classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Diverticulitis}} | {{Diverticulitis}} | ||
{{CMG}} {{AE}} | {{CMG}}; {{AE}} {{DAMI}} | ||
{{ | |||
==Overview== | ==Overview== | ||
Diverticular diseases may be classified based on the presenting [[Symptoms and Signs|signs and symptoms]] according to the German guidelines that were published by the German Society of Gastroenterology (DGVS) and of Visceral Surgery (DGAV) in 2014. This aggreed upon classification system (Classification of Diverticular Disease (CDD), takes [[Symptoms and Signs|signs and symptoms]], natural history ([[symptomatic]], [[asymptomatic]], [[Complication|complicated]], uncomplicated, [[acute]], recurrent), surgical aspects ([[purulent]] vs. fecal [[peritonitis]]), and clinically relevant diagnostic tests into account. As a result, this [[classification]] comprises the entire [[spectrum]] of diverticular disease. | |||
==Classification== | ==Classification== | ||
The following table describes the classification of diverticular disease according to the German guidelines (in 2014) by the German Societies of Gastroenterology (DGVS) and of Visceral Surgery (DGAV).<ref name="Lembcke2015">{{cite journal|last1=Lembcke|first1=Bernhard|title=Diagnosis, Differential Diagnoses, and Classification of Diverticular Disease|journal=Viszeralmedizin|volume=31|issue=2|year=2015|pages=95–102|issn=1662-6664|doi=10.1159/000380833}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|- | |- | ||
! style="background: #4479BA; padding: 5px 5px;" | ! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Type}} | ||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 | ! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Subtype}} | ||
! | ! rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Description}} | ||
! rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Features}} | |||
|- | |- | ||
|'''Type 0''' | |||
'''(Asymptomatic diverticulosis)''' | |||
|Type 0 | |Type 0 | ||
|None | |||
| | | | ||
* Incidental finding | |||
* | |||
* | * [[Asymptomatic]]; not a disease per se | ||
|- | |- | ||
| rowspan="2" |Type 1 | | rowspan="2" |'''Type 1''' | ||
Acute uncomplicated diverticulitis | '''(Acute uncomplicated diverticulitis)''' | ||
|Type 1a | |Type 1a | ||
| | |Diverticulitis without peridiverticulitis | ||
| | | | ||
* [[Symptoms]] attributable to [[Diverticulum|diverticula]] | |||
* [[Medical sign|Signs]] of [[inflammation]] present | |||
* Typical cross-sectional imaging | |||
|- | |- | ||
|Type 1b | |Type 1b | ||
| | |Diverticulitis with phlegmonous peridiverticulitis | ||
| | | | ||
* Signs of [[inflammation]] on laboratory tests | |||
* Cross-sectional imaging demonstrates phlegmonous diverticulitis | |||
|- | |- | ||
| rowspan="5" |Type 2 | | rowspan="5" |'''Type 2''' | ||
Acute complicated diverticulitis | '''(Acute complicated diverticulitis)''' | ||
|Type 2a | |Type 2a | ||
| | |[[Abscess|Microabscess]] | ||
| | | | ||
* Concealed [[perforation]] | |||
* Small [[abscess]] (≤1 cm) | |||
* Minimal [[Paracolic gutters|paracolic]] air | |||
|- | |- | ||
|Type 2b | |Type 2b | ||
| | |Macro-[[abscess]] | ||
|Paracolic or mesocolic abscess (>1 cm) | | | ||
* Paracolic or [[Mesocolic lymph nodes|mesocolic]] [[abscess]] (>1 cm) | |||
|- | |- | ||
|Type 2c | |Type 2c | ||
| | |Free [[perforation]] | ||
| | | rowspan="3" | | ||
* Free [[perforation]], free air/fluid | |||
* Generalized [[peritonitis]] | |||
|- | |- | ||
|Type 2c1 | |Type 2c1 | ||
| | |[[Purulent peritonitis]] | ||
|- | |- | ||
|Type 2c2 | |Type 2c2 | ||
| | |Fecal [[peritonitis]] | ||
|- | |- | ||
| rowspan="3" |Type 3 | | rowspan="3" |'''Type 3''' | ||
Chronic diverticular disease (relapsing or persistent) | '''Chronic diverticular disease (relapsing or persistent)''' | ||
|Type 3a | |Type 3a | ||
| | |[[Symptomatic]] uncomplicated [[diverticular disease]] (SUDD) | ||
| | | | ||
* Localized symptoms | |||
* Laboratory test (calprotectin) | |||
|- | |- | ||
|Type 3b | |Type 3b | ||
| | |Relapsing diverticulitis without complications | ||
| | | | ||
* Signs of [[inflammation]] present | |||
* Cross-sectional imaging indicates [[inflammation]] | |||
|- | |- | ||
|Type 3c | |Type 3c | ||
| | |Relapsing diverticulitis with complications | ||
| | | | ||
* Identification of [[stenosis]], [[fistulas]], conglomerate [[tumor]] | |||
|- | |- | ||
|'''Type 4''' | |||
'''(Diverticular bleeding)''' | |||
|Type 4 | |Type 4 | ||
Diverticular bleeding | |Diverticular [[bleeding]] | ||
| | | | ||
* Diverticula identified as the source of [[bleeding]] | |||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Surgery]] | [[Category:Surgery]] | ||
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[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 21:26, 29 July 2020
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Diverticulitis Microchapters |
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Diverticulitis classification On the Web |
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American Roentgen Ray Society Images of Diverticulitis classification |
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Risk calculators and risk factors for Diverticulitis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]
Overview
Diverticular diseases may be classified based on the presenting signs and symptoms according to the German guidelines that were published by the German Society of Gastroenterology (DGVS) and of Visceral Surgery (DGAV) in 2014. This aggreed upon classification system (Classification of Diverticular Disease (CDD), takes signs and symptoms, natural history (symptomatic, asymptomatic, complicated, uncomplicated, acute, recurrent), surgical aspects (purulent vs. fecal peritonitis), and clinically relevant diagnostic tests into account. As a result, this classification comprises the entire spectrum of diverticular disease.
Classification
The following table describes the classification of diverticular disease according to the German guidelines (in 2014) by the German Societies of Gastroenterology (DGVS) and of Visceral Surgery (DGAV).[1]
| Type | Subtype | Description | Features |
|---|---|---|---|
| Type 0
(Asymptomatic diverticulosis) |
Type 0 | None |
|
| Type 1
(Acute uncomplicated diverticulitis) |
Type 1a | Diverticulitis without peridiverticulitis |
|
| Type 1b | Diverticulitis with phlegmonous peridiverticulitis |
| |
| Type 2
(Acute complicated diverticulitis) |
Type 2a | Microabscess |
|
| Type 2b | Macro-abscess | ||
| Type 2c | Free perforation |
| |
| Type 2c1 | Purulent peritonitis | ||
| Type 2c2 | Fecal peritonitis | ||
| Type 3
Chronic diverticular disease (relapsing or persistent) |
Type 3a | Symptomatic uncomplicated diverticular disease (SUDD) |
|
| Type 3b | Relapsing diverticulitis without complications |
| |
| Type 3c | Relapsing diverticulitis with complications | ||
| Type 4
(Diverticular bleeding) |
Type 4 | Diverticular bleeding |
|
References
- ↑ Lembcke, Bernhard (2015). "Diagnosis, Differential Diagnoses, and Classification of Diverticular Disease". Viszeralmedizin. 31 (2): 95–102. doi:10.1159/000380833. ISSN 1662-6664.