Appendicitis other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Alvarado score

A number of clinical and laboratory based scoring systems have been devised to assist the diagnosis of appendicitis. The most widely used is the Alvarado score:

Symptoms:

• Migratory right iliac fossa pain - 1 point
• Anorexia - 1 point
• Nausea and vomiting - 1 point

Signs:

• Right iliac fossa tenderness - 2 points
• Rebound tenderness - 1 point
• Fever - 1 point

Laboratory:

• Leucocytosis - 2 points
• Shift to left (segmented neutrophils) - 1 point

Total score = 10.

A score of 7 or more is strongly predictive of acute appendicitis.
In patients with an equivocal score of 5-6, CT scan further reduces the rate of negative appendicectomy.