Diverticulitis classification: Difference between revisions
| Line 21: | Line 21: | ||
|None | |None | ||
| | | | ||
* Incidental finding | * Incidental finding | ||
*[[Asymptomatic]]; not a disease per se | |||
* [[Asymptomatic]]; not a disease per se | |||
|- | |- | ||
| rowspan="2" |Type 1 | | rowspan="2" |Type 1 | ||
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|Type 1a | |Type 1a | ||
|Diverticulitis without peridiverticulitis | |Diverticulitis without peridiverticulitis | ||
|Symptoms attributable to [[Diverticulum|diverticula]] | | | ||
* Symptoms attributable to [[Diverticulum|diverticula]] | |||
* Signs of [[inflammation]] present | |||
* Typical cross-sectional imaging | |||
|- | |- | ||
|Type 1b | |Type 1b | ||
|Diverticulitis with phlegmonous peridiverticulitis | |Diverticulitis with phlegmonous peridiverticulitis | ||
|Signs of [[inflammation]] | | | ||
* Signs of [[inflammation]] on laboratory tests | |||
* Cross-sectional imaging demonstrates phlegmonous diverticulitis | |||
|- | |- | ||
| rowspan="5" |Type 2 | | rowspan="5" |Type 2 | ||
| Line 38: | Line 46: | ||
|Type 2a | |Type 2a | ||
|[[Abscess|Microabscess]] | |[[Abscess|Microabscess]] | ||
|Concealed [[perforation]] | | | ||
* Concealed [[perforation]] | |||
* Small [[abscess]] (≤1 cm) | |||
* Minimal paracolic air | |||
|- | |- | ||
|Type 2b | |Type 2b | ||
|Macroabscess | |Macroabscess | ||
|Paracolic or [[Mesocolic lymph nodes|mesocolic]] [[abscess]] (>1 cm) | | | ||
* Paracolic or [[Mesocolic lymph nodes|mesocolic]] [[abscess]] (>1 cm) | |||
|- | |- | ||
|Type 2c | |Type 2c | ||
|Free [[perforation]] | |Free [[perforation]] | ||
|Free [[perforation]], free air/fluid | | rowspan="3" | | ||
* Free [[perforation]], free air/fluid | |||
* Generalized [[peritonitis]] | |||
|- | |- | ||
|Type 2c1 | |Type 2c1 | ||
|[[Purulent peritonitis]] | |[[Purulent peritonitis]] | ||
|- | |- | ||
|Type 2c2 | |Type 2c2 | ||
|Fecal [[peritonitis]] | |Fecal [[peritonitis]] | ||
|- | |- | ||
| rowspan="3" |Type 3 | | rowspan="3" |Type 3 | ||
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|Type 3a | |Type 3a | ||
|Symptomatic uncomplicated [[diverticular disease]] (SUDD) | |Symptomatic uncomplicated [[diverticular disease]] (SUDD) | ||
|Localized symptoms | | | ||
* Localized symptoms | |||
* Laboratory test (calprotectin) | |||
|- | |- | ||
|Type 3b | |Type 3b | ||
|Relapsing diverticulitis without complications | |Relapsing diverticulitis without complications | ||
|Signs of [[inflammation]] | | | ||
* Signs of [[inflammation]] present | |||
* Cross-sectional imaging indicates inflammation | |||
|- | |- | ||
|Type 3c | |Type 3c | ||
|Relapsing diverticulitis with complications | |Relapsing diverticulitis with complications | ||
|Identification of [[stenosis]], [[fistulas]], conglomerate [[tumor]] | | | ||
* Identification of [[stenosis]], [[fistulas]], conglomerate [[tumor]] | |||
|- | |- | ||
|Type 4 | |Type 4 | ||
Diverticular bleeding | Diverticular bleeding | ||
|Type 4 | |Type 4 | ||
|Diverticular bleeding | |||
| | | | ||
* Diverticula identified as the source of [[bleeding]] | |||
|} | |} | ||
Revision as of 14:30, 30 August 2017
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Diverticulitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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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 according to the German guidelines that were passed by the German Society of Gastroenterology (DGVS) and of Visceral Surgery (DGAV) in 2014. They unanimously agreed on a classification system (Classification of Diverticular Disease (CDD)), that takes practical algorithms (symptomatic, asymptomatic, complicated, uncomplicated, acute, recurrent), ongoing surgical aspects (purulent vs. fecal peritonitis), and contemporary diagnostic standards in clinical practice into account. As a result, this classification comprises the entire spectrum of diverticular disease.[1]
Classification
The diverticular disease may be classified according to the German guidelines that were recently passed (in 2014) by the German Societies of Gastroenterology (DGVS) and of Visceral Surgery (DGAV). They classified it into symptomatic, asymptomatic, complicated, uncomplicated, acute, and recurrent.[2]
| 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 | Macroabscess | ||
| 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. More than one of
|author=and|last1=specified (help) - ↑ Lembcke, Bernhard (2015). "Diagnosis, Differential Diagnoses, and Classification of Diverticular Disease". Viszeralmedizin. 31 (2): 95–102. doi:10.1159/000380833. ISSN 1662-6664.