Eskelinen et al developed a score for the diagnosis of acute appendicitis.
Patient selection: acute abdominal pain
Parameters:
(1) abdominal tenderness
(2) abdominal rigidity
(3) rebound tenderness
(4) white blood cell count
(5) location of pain at diagnosis
(6) duration of pain in hours
|
Parameter |
Finding |
Points |
|
abdominal tenderness |
in lower right quadrant |
2 |
|
|
elsewhere |
1 |
|
abdominal rigidity |
no |
1 |
|
|
yes |
2 |
|
rebound tenderness |
no |
1 |
|
|
yes |
2 |
|
WBC count |
< 10,000 per µL |
1 |
|
|
>= 10,000 per µL |
2 |
|
location of pain |
in right lower quadrant |
2 |
|
|
elsewhere |
1 |
|
duration of pain |
< 48 hours |
2 |
|
|
>= 48 hours |
1 |
total score =
= (11.41 * (points for tenderness)) + (6.62 * (points for rigidity)) + (4.25 * (points for rebound)) + (5.88 * (points for WBC count)) + (3.51 * (points for pain location)) + (2.13 * (points for duration of pain))
Interpretation:
• The higher the score the more likely the patient has acute appendicitis.
|
Total Score |
Management |
|
< 50 |
appendicitis excluded |
|
50 - 57 |
observe |
|
> 57 |
operate |
Specialty: Gastroenterology, Pedatrics, General Surgery
