February 23, 2010

Alvarado Score for Appendicitis

Use the mnemonic MANTRELS

Migration to the right iliac fossa (1),

Anorexia (1),

Nausea/Vomiting (1),

Tenderness in the right iliac fossa(2),

Rebound pain (1),

Elevated temperature (fever) (1),

Leukocytosis (2),

Shift of leukocytes to the left (1)


5-6 (Acute Appendicitis)

7-8 (Probable appendicitis)

9-10 (Very probable)

Notes: Modified Alvarado is used in center who unable to perform a differential white blood cell count where the total score is 9

download this pdf file [here]


  1. Salam Dr.

    What does "shift of leucocytes to the left" mean?

    1. In establish center, they have special lab with that data.. In our.setting, we only use leucocytosis


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