Hinchey Classification
Stages complicated diverticulitis severity by degree of peritoneal contamination to guide surgical vs medical management
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- classification
- Care settings
- Emergency department, ICU, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The Hinchey Classification can activate when the transcript or pasted chart context documents any of these:
- Complicated diverticulitis staging
- Diverticular abscess management
- Diverticulitis surgical decision
- Perforated diverticulitis classification
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: K57.
Note-type scope: it activates on notes whose subject resolves to gi, perioperative, hospital medicine, emergency medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Hinchey stage (1-4) | exam |
Scoring
Stage I: Pericolic/mesenteric abscess. Stage II: Pelvic, distant, or retroperitoneal abscess. Stage III: Generalized purulent peritonitis. Stage IV: Generalized fecal peritonitis.
Interpretation
Stage I: Antibiotics ± percutaneous drainage if >3cm. Stage II: Percutaneous drainage + antibiotics. Stage III: Surgical intervention (lavage vs resection). Stage IV: Emergency surgery (Hartmann procedure or primary anastomosis with diverting ileostomy).
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Hinchey EJ et al. 1978.
- Hinchey EJ et al. Treatment of perforated diverticular disease of the colon (Hinchey Classification)Hinchey et al. 1978 · 1978 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Hinchey Classification (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Hinchey Classification value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a staging or classification system: activated strictly, because a wrong stage on the wrong patient is a documentation hazard.
See it activate on your own encounter
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