Emergency Medicine

Alvarado Score (MANTRELS) for Acute Appendicitis

Calculates Alvarado score (0–10) from symptoms, signs, and labs to guide CT imaging and urgent appendectomy.

Parameters

Alvarado Score (MANTRELS) for Acute Appendicitis Result

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FormulaAlvarado Score (MANTRELS) = Migratory RLQ pain (1) + Anorexia (1) + Nausea (1) + RLQ Tenderness (2) + Rebound tenderness (1) + Temp ≥37.3°C (1) + Leukocytosis >10k (2) + Left shift (1)

Clinical Pearls

World-renowned diagnostic tool reducing negative appendectomy rates and identifying patients requiring urgent surgical exploration.

Limitations

Lower specificity in female patients of childbearing age due to gynecological mimics; pelvic ultrasound or CT imaging is recommended.