The Surgical Rate and Recurrence Rate in Right Colonic Diverticulitis Using the CT-Based Modified Hinchey Classification

• Published in: Journal of the Korean Society of Radiology Vol. 73; no. 2; pp. 91 - 99
• Main Authors: Kim, Dong Hwan, Kim, Hyuk Jung, Jang, Suk Ki, Yeon, Jae Woo, Ko, Yousun, Lee, Kyoung Ho
• Format: Journal Article
• Language: English
• Published: 대한영상의학회 01-08-2015
• Subjects: 방사선과학
• ISSN: 1738-2637; 2288-2928; 2951-0805
• DOI: 10.3348/jksr.2015.73.2.91

Purpose: The purpose of this report is to retrospectively analyze the need for surgery, and the recurrence rate, using a CT-based method in patients with right colonic diverticulitis.
Materials and Methods: For the purposes of our study, we included 416 patients with a mean age of 41.9 (238 of which were men), with a diagnosis of colonic diverticulitis that was based on CT findings. These findings were reviewed by two independent radiologists, who localized diverticulitis and determined it using a modified Hinchey classification. We were able to follow-up with 384 patients over a period of 30 months.
Results: Out of the 416 patients, 396 of them had right colonic diverticulitis. In right colonic diverticulitis, the κ value in determining the modified Hinchey classification was 0.80. 98.2% (389/396) of the patients with right colonic diverticulitis had stages Ia–II. The surgery rate was 4.6% (17/366) and 28% (5/18) for right and left colonic diverticulitis, respectively (p < 0.001). In the instances of right colonic diverticulitis, the surgery rate was 2.8% (10/359) for stages Ia–II, while all seven patients with stage III or IV underwent surgery. The recurrence rate was 6.5% (23/356) and 15% (2/13) for right and left colonic diverticulitis, respectively (p = 0.224).
Conclusion: The CT-based modified Hinchey classification of right colonic diverticulitis showed good interobserver agreement. Most patients with right colonic diverticulitis had lower stages (Ia–II) at the point of CT, rarely needed surgery, and had a low recurrence rate. KCI Citation Count: 0