Manual Kalan (Full Score)

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Hoffmann J, Rasmussen OO. Aids in the diagnosis of acute appendicitis.

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A practical score for the early diagnosis of acute appendicitis. Evaluation of the Alvarado score in acute appendicitis. J R Soc Med.

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  • Alvarado score.
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ACCET promotes quality-oriented education and training through establishment of standards for its members and an accreditation process focused on integrity. Alvarado described a clinical scoring system on the basis of eight predictive clinical factors to improve the accuracy of physicians' clinical assessments in diagnosing acute appendicitis. This scoring system produces a maximum total score of 10 points and includes clinical symptoms nausea and anorexia , signs fever, shifting pain, right lower quadrant pain, and rebound tenderness and laboratory findings leukocytosis and neutrophilia.

Right lower quadrant pain and leukocytosis contribute 2 points while the rest contributes 1 point 2.


The modified Alvarado score MAS has been widely accepted after it was successfully tested in different studies 1. The aim of this study was to evaluate sensitivity, specificity, positive predictive value, and negative predictive value of modified Alvarado score in children who underwent appendectomy. It included children with diagnosis of appendicitis during Of children who underwent appendectomy children were randomly selected. Appendicitis was confirmed according to pathology report. Modified Alvarado score was used to evaluate appendicitis 4.

Modified Alvarado score is based on three symptoms, three signs, and one laboratory investigation and ranged from Table 1. Of these cases, Of all cases, 63 As seen in Table 2 , anorexia, nausea and vomiting, and rebound tenderness were significantly more common in children with appendicitis than children without appendicitis. Migratory right iliac fossa pain was the most sensitive part of MAS Table 3. Of 48 children with score , 45 had negative histopathology Table 4. As seen in Table 4 , all children with score had positive histopathology.

In the current study, sensitivity of MAS was In the study by Khanafer et al.

In another study from India in adult patients, MAS was sensitive but with a relatively low specificity 9. Specificity of MAS was