Diverticulitis classification: Difference between revisions

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{{Diverticulitis}}
{{CMG}}; {{AE}} {{DAMI}}
==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==
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"
|-
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Type}}
! 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
|None
|
* Incidental finding
* [[Asymptomatic]]; not a disease per se
|-
| rowspan="2" |'''Type 1'''
'''(Acute uncomplicated diverticulitis)'''
|Type 1a
|Diverticulitis without peridiverticulitis
|
* [[Symptoms]] attributable to [[Diverticulum|diverticula]]
* [[Medical sign|Signs]] of [[inflammation]] present


{{Diverticulitis}}
* Typical cross-sectional imaging
|-
|Type 1b
|Diverticulitis with phlegmonous peridiverticulitis
|
* Signs of [[inflammation]]  on laboratory tests
* Cross-sectional imaging demonstrates phlegmonous diverticulitis
|-
| rowspan="5" |'''Type 2'''
'''(Acute complicated diverticulitis)'''
|Type 2a
|[[Abscess|Microabscess]]
|
* Concealed [[perforation]]
* Small [[abscess]] (≤1 cm)
* Minimal [[Paracolic gutters|paracolic]] air
|-
|Type 2b
|Macro-[[abscess]]
|
* Paracolic or [[Mesocolic lymph nodes|mesocolic]] [[abscess]] (>1 cm)
|-
|Type 2c
|Free [[perforation]]
| rowspan="3" |
* Free [[perforation]], free air/fluid
 
* Generalized [[peritonitis]]
|-
|Type 2c1
|[[Purulent peritonitis]]
|-
|Type 2c2
|Fecal [[peritonitis]]
|-
| rowspan="3" |'''Type 3'''
'''Chronic diverticular disease (relapsing or persistent)'''
|Type 3a
|[[Symptomatic]] uncomplicated [[diverticular disease]] (SUDD)
|
* Localized symptoms
 
* Laboratory test (calprotectin)
|-
|Type 3b
|Relapsing diverticulitis without complications
|
* Signs of [[inflammation]] present


Please help WikiDoc by adding content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]] to learn about editing.
* Cross-sectional imaging indicates [[inflammation]]
|-
|Type 3c
|Relapsing diverticulitis with complications
|
* Identification of [[stenosis]], [[fistulas]], conglomerate [[tumor]]
|-
|'''Type 4'''
'''(Diverticular bleeding)'''
|Type 4
|Diverticular [[bleeding]]
|
* Diverticula identified as the source of [[bleeding]]
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 21:26, 29 July 2020

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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
  • Incidental finding
Type 1

(Acute uncomplicated diverticulitis)

Type 1a Diverticulitis without peridiverticulitis
  • Typical cross-sectional imaging
Type 1b Diverticulitis with phlegmonous peridiverticulitis
  • Signs of inflammation on laboratory tests
  • Cross-sectional imaging demonstrates phlegmonous diverticulitis
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)
  • Localized symptoms
  • Laboratory test (calprotectin)
Type 3b Relapsing diverticulitis without complications
Type 3c Relapsing diverticulitis with complications
Type 4

(Diverticular bleeding)

Type 4 Diverticular bleeding
  • Diverticula identified as the source of bleeding

References

  1. ↑ Lembcke, Bernhard (2015). "Diagnosis, Differential Diagnoses, and Classification of Diverticular Disease". Viszeralmedizin. 31 (2): 95–102. doi:10.1159/000380833. ISSN 1662-6664.

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