{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:45:20Z","timestamp":1780393520007,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Severity of acute diverticulitis (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>) has traditionally been assessed using the Hinchey classification; however, this classification is predominantly a surgical one. The Neff classification provides an alternative classification based on <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> findings. The aim of this study was to evaluate a modification of the Neff classification to select patients presenting with early\u2010stage <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> to receive outpatient management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>All patients with AD, presenting to a single unit, were prospectively studied. All patients underwent emergency abdominal <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> and were assigned a <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>eff stage, including a modification (m<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>eff) to <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>eff <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tage I. The <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>eff stages used were: Stage 0, uncomplicated diverticulitis; Diverticula, thickening of the wall, increased density of the pericolic fat; Stage I, locally complicated (our modification included substages Ia (localized pneumoperitoneum in the form of air bubbles) and Ib (local abscess); <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tage II, complicated with pelvic abscess; <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tage III, complicated with distant abscess; and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tage IV, complicated with other distant complications. Patients who presented with Stage 0 or Stage Ia were selectively managed as outpatients. Patients with comorbidity or the presence of the systemic inflammatory response syndrome (<jats:styled-content style=\"fixed-case\">SIRS<\/jats:styled-content>) were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between February 2010 and January 2013, 205 patients (mean age 59\u00a0years; age range 25\u201390\u00a0years) presented with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>. One\u2010hundred and forty\u2010nine met the radiological criteria for potential outpatient treatment. After applying the exclusion criteria, 68 were eventually assigned to an outpatient programme. Sixty\u2010four (94%) successfully completed the outpatient treatment protocol; four patients were readmitted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our <jats:styled-content style=\"fixed-case\">mN<\/jats:styled-content>eff classification allowed selected patients with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> to be successfully managed in an outpatient programme.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12449","type":"journal-article","created":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T21:03:53Z","timestamp":1383685433000},"page":"1442-1447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Application of a modified <scp>N<\/scp>eff classification to patients with uncomplicated diverticulitis"],"prefix":"10.1111","volume":"15","author":[{"given":"L.","family":"Mora Lopez","sequence":"first","affiliation":[{"name":"Coloproctology Unit of General and Digestive Surgery Service Hospital Universitari Parc Tauli (Sabadell) Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Serra Pla","sequence":"additional","affiliation":[{"name":"Coloproctology Unit of General and Digestive Surgery Service Hospital Universitari Parc Tauli (Sabadell) Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Serra\u2010Aracil","sequence":"additional","affiliation":[{"name":"Coloproctology Unit of General and Digestive Surgery Service Hospital Universitari Parc Tauli (Sabadell) Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Ballesteros","sequence":"additional","affiliation":[{"name":"Radiodiagnosis Service Hospital Universitari Parc Tauli (Sabadell) Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Navarro","sequence":"additional","affiliation":[{"name":"Chief of General and Digestive Surgery Service Hospital Universitari Parc Tauli (Sabadell) Sabadell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,5]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"225","article-title":"Infecciones quirurgicas \u2013Diverticulitis","volume":"11","author":"Garcia\u2010Domingo MI","year":"2006","journal-title":"Guias cl\u00ednicas de la Asociaci\u00f3n Espa\u00f1ola de Cirujanos. 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