Abdominal and GI imaging: Hinchey classification: practice question

A Radiology 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.

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Radiology · Abdominal and GI imaging: Hinchey classification

Sample item

A patient with left iliac fossa pain has CT showing sigmoid diverticula with wall thickening, pericolic fat stranding and a 5 cm rim-enhancing collection in the pelvis, distant from the colon. There is no free gas or generalised peritonitis. What is the Hinchey stage?

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

The answer and the reasoning

D. Stage II

In the Hinchey classification, stage I is a pericolic abscess or phlegmon, stage II a pelvic, intra-abdominal or retroperitoneal abscess, stage III generalised purulent peritonitis, and stage IV faecal peritonitis. A distant pelvic abscess is stage II and is often treated by percutaneous drainage.

Option by option

  • A. Stage III

    Stage III is generalised purulent peritonitis from a ruptured abscess.

  • B. Stage IV

    Stage IV is faecal peritonitis from a free perforation of the diseased colon.

  • C. Stage I

    Stage I is limited to a pericolic abscess or phlegmon adjacent to the colon.

  • D. Stage II (correct)

    Correct. A distant pelvic abscess without generalised peritonitis is stage II.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Stage II. In the Hinchey classification, stage I is a pericolic abscess or phlegmon, stage II a pelvic, intra-abdominal or retroperitoneal abscess, stage III generalised purulent peritonitis, and stage IV faecal peritonitis.

Why is "Stage III" not the answer?

Stage III is generalised purulent peritonitis from a ruptured abscess.

Why is "Stage IV" not the answer?

Stage IV is faecal peritonitis from a free perforation of the diseased colon.

Why is "Stage I" not the answer?

Stage I is limited to a pericolic abscess or phlegmon adjacent to the colon.

What concept does this question test?

It tests Abdominal and GI imaging: Hinchey classification in Radiology. A distant pelvic abscess is stage II and is often treated by percutaneous drainage.

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 Abdominal and GI imaging: Hinchey classification?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.