Surgery
Alvarado Score (MANTRELS)
Evaluates the likelihood of acute appendicitis.
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Parameters
Alvarado Score (MANTRELS) Result
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Formula
Sum of MANTRELS criteria. Tenderness (RLQ) and Leukocytosis are worth 2 points each, others are 1 point.Clinical Pearls
Highly sensitive for ruling out appendicitis at low scores (<4) and useful for deciding who needs imaging vs direct surgical consultation.
Limitations
Less accurate in children and women of child-bearing age where gynecological pathology can mimic appendicitis. Imaging is frequently still required in moderate/high risk patients.