Hinchey Classification

Name: Hinchey Classification calculator — MedScore
Creator: Nabil Alzein

Perforated diverticulitis — abscess and peritonitis stages

Hinchey stage

Tap the one that applies — its meaning opens right below.

I — pericolic abscess

II — pelvic (distant) abscess

III — generalised purulent peritonitis

IV — faecal peritonitis

About this score

When to use

Classifies perforated diverticulitis by severity, from pericolic or pelvic abscess to purulent and faecal peritonitis. ⁦[1]⁩

Pearls and pitfalls

Faecal peritonitis, with a persisting communication to the bowel lumen, carried an extremely high mortality in the original series. ⁦[1]⁩

Summarised from the numbered sources under Evidence. Check the source before relying on a statement.

Evidence

[1] Original publication

Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Describes the progression from pericolic or pelvic abscess to purulent peritonitis after free perforation and, with a persisting communication to the bowel lumen, faecal peritonitis — which carried an extremely high mortality.

Advances in Surgery, 1978

Open source

Last reviewed: 2026-10

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.