Gastrointestinal surgery: Hinchey classification: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Gastrointestinal surgery: Hinchey classification

Sample item

A 67-year-old man with left iliac fossa pain and fever has signs of generalised peritonitis. At laparotomy there is purulent fluid throughout the peritoneal cavity from a ruptured pericolic abscess. No faecal contamination is seen and the colonic perforation is not visible. Which Hinchey stage is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Stage III

The Hinchey classification of perforated diverticulitis is stage I pericolic abscess, stage II pelvic, distant or retroperitoneal abscess, stage III generalised purulent peritonitis and stage IV generalised faecal peritonitis. This patient has purulent peritonitis without faecal soiling, so stage III.

Option by option

  • A. Stage I

    Stage I is a localised pericolic abscess or phlegmon and not a generalised peritoneal process.

  • B. Stage II

    Stage II is a distant, pelvic or retroperitoneal abscess that remains walled off.

  • C. Stage III (correct)

    Correct. Generalised purulent peritonitis without faecal contamination is stage III.

  • D. Stage IV

    Stage IV needs free perforation with faecal peritonitis, which is not present here.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Stage III. The Hinchey classification of perforated diverticulitis is stage I pericolic abscess, stage II pelvic, distant or retroperitoneal abscess, stage III generalised purulent peritonitis and stage IV generalised faecal peritonitis.

Why is "Stage I" not the answer?

Stage I is a localised pericolic abscess or phlegmon and not a generalised peritoneal process.

Why is "Stage II" not the answer?

Stage II is a distant, pelvic or retroperitoneal abscess that remains walled off.

Why is "Stage IV" not the answer?

Stage IV needs free perforation with faecal peritonitis, which is not present here.

What concept does this question test?

It tests Gastrointestinal surgery: Hinchey classification in General Surgery. This patient has purulent peritonitis without faecal soiling, so stage III.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: Hinchey classification?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.