What symptoms are helpful in evaluating for appendicitis

What symptoms are helpful in evaluating for appendicitis

It is decidedly uncommon for acute appendicitis to present with nausea, vomiting, or diarrhea before abdominal pain. Usually acute appendicitis is heralded by pain and often followed by anorexia, nausea, and sometimes single-episode vomiting. Acute appendicitis should be first on the differential diagnosis list in any patient with acute abdominal pain without a prior history of appendectomy. A simple scoring system of clinical parameters and laboratory tests, the Alvarado score, has been validated to be very predictive of acute appendicitis.

Alvarado Score

SymptomsScore
Migration of pain to right iliac fossa1
Anorexia1
Nausea and vomiting1
Signs
Raised temperature, > 37.3° C1
Rebound pain1
Tenderness in the right iliac fossa2

Laboratory Findings

Elevated leukocyte counts 2

Neutrophil left shift (> 75%)1

Total 10

Score = 5-6 possible appendicitis

Score = 7-8 probable appendicitis

Score = 9-10 very probable appendicitis

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