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Appendicitis Medication

  • Author: Sandy Craig, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
 
Updated: Dec 27, 2015
 

Medication Summary

The goals of therapy are to eradicate the infection and to prevent complications. Thus, antibiotics have an important role in the treatment of appendicitis, and all such. Agents under consideration must offer full aerobic and anaerobic coverage. The duration of the administration is closely related to the stage of appendicitis at the time of the diagnosis.

Antibiotic agents are effective in decreasing the rate of postoperative wound infection and in improving outcome in patients with appendiceal abscess or septicemia. The Surgical Infection Society recommends starting prophylactic antibiotics before surgery, using appropriate spectrum agents for less than 24 hours for nonperforated appendicitis and for less than 5 days for perforated appendicitis. Regimens are of approximately equal efficacy, so consideration should be given to features such as medication allergy, pregnancy category (if applicable), toxicity, and cost.

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Penicillins

Class Summary

The penicillins are bactericidal antibiotics that work against sensitive organisms at adequate concentrations and inhibit the biosynthesis of cell wall mucopeptide.

Piperacillin and tazobactam sodium (Zosyn)

 

This agent is a drug combination of beta-lactamase inhibitor with piperacillin. It has activity against some gram-positive organisms, gram-negative organisms, and anaerobic bacteria. When used as a single agent, it inhibits biosynthesis of cell wall mucopeptide and is effective during active multiplication stages.

Ampicillin and sulbactam (Unasyn)

 

This agent is a drug combination of beta-lactamase inhibitor with ampicillin. It is used as a single agent and interferes with bacterial cell wall synthesis during active replication, causing bactericidal activity against susceptible organisms. Ampicillin/sulbactam also has activity against some gram-positive organisms, gram-negative organisms (nonpseudomonal species), and anaerobic bacteria.

Ticarcillin/clavulanate (Timentin)

 

Ticarcillin/clavulanate inhibits biosynthesis of cell wall mucopeptide and is effective during the stage of active growth. It is an antipseudomonal penicillin plus beta-lactamase inhibitor that provides coverage against most gram-positive organisms, most gram-negative organisms, and most anaerobic organisms.

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Cephalosporins

Class Summary

Cephalosporins are structurally and pharmacologically related to penicillins. They inhibit bacterial cell wall synthesis, resulting in bactericidal activity.

Cefotetan (Cefotan)

 

Cefotetan is a second-generation cephalosporin that is used as single-drug therapy for broad gram-negative and anaerobic coverage. Administer cefotetan with cefoxitin to achieve the effectiveness of single dose. Its half-life is 3.5 hours.

Cefoxitin (Mefoxin)

 

This drug is also a second-generation cephalosporin that is indicated as single agent for the management of infections caused by susceptible gram-positive cocci and gram-negative rods. It has a half-life of 0.8 hours.

Cefepime

 

Cefepime is a fourth-generation cephalosporin. It has gram-negative coverage comparable to ceftazidime but has better gram-positive coverage. Cefepime is a zwitter ion that rapidly penetrates gram-negative cells.

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Aminoglycosides

Class Summary

Aminoglycosides have concentration-dependent bactericidal activity. These agents work by binding to the 30S ribosome, inhibiting bacterial protein synthesis.

Gentamicin (Gentacidin, Garamycin)

 

Gentamicin is an aminoglycoside antibiotic used for gram-negative coverage, as well as in combination with an agent against gram-positive organisms and another one against anaerobes. Gentamicin is not the drug of choice, but consider using this drug if penicillins or other less toxic drugs are contraindicated, when it is clinically indicated, and in mixed infections caused by susceptible staphylococci and gram-negative organisms. This agent may be administered intravenously or intramuscularly and has numerous regimens; the dose must be adjusted for creatinine clearance and changes in volume of distribution.

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Carbapenems

Class Summary

Carbapenems are structurally related to penicillins and have broad-spectrum bactericidal activity. The carbapenems exert their effect by inhibiting cell wall synthesis, which leads to cell death. They are active against gram-negative, gram-positive, and anaerobic organisms.

Meropenem (Merrem)

 

Meropenem is a bactericidal broad-spectrum carbapenem antibiotic that inhibits cell wall synthesis. It is used as a single agent and is effective against most gram-positive and gram-negative bacteria.

Ertapenem

 

Ertapenem has bactericidal activity that results from the inhibition of cell wall synthesis and is mediated through ertapenem binding to penicillin-binding proteins. It is stable against hydrolysis by a variety of beta-lactamases, including penicillinase, cephalosporinase, and extended-spectrum beta-lactamases.

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Fluoroquinolones

Class Summary

These agents can be used to relieve acute undifferentiated abdominal pain in patients presenting to the ED.

Ciprofloxacin (Cipro)

 

Ciprofloxacin is a fluoroquinolone that inhibits bacterial DNA synthesis and, consequently, growth, by inhibiting DNA gyrase and topoisomerase, which are required for replication, transcription, and translation of genetic material. Quinolones have broad activity against gram-positive and gram-negative aerobic organisms.

Levofloxacin (Levaquin)

 

Levofloxacin is used for infections caused by various gram-negative organisms, antipseudomonal infections due to multidrug resistant gram-negative organisms.

Moxifloxacin (Avelox)

 

Moxifloxacin is a fluoroquinolone that inhibits A subunits of DNA gyrase, inhibiting bacterial DNA replication and transcription.

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Anti-infective Agents

Class Summary

Anti-infectives such as metronidazole and tigecycline are effective against many types of bacteria that have become resistant to other antibiotics.

Metronidazole (Flagyl)

 

Metronidazole has broad gram-negative and anaerobic coverage and is used in combination with aminoglycosides (eg, gentamicin). This agent appears to be absorbed into cells; intermediate metabolized compounds bind DNA and inhibit protein synthesis, causing cell death.

Tigecycline (Tygacil)

 

Tigecycline is a glycylcycline antibiotic that is structurally similar to tetracycline antibiotics. It inhibits bacterial protein translation by binding to the 30S ribosomal subunit, and it blocks entry of amino-acyl tRNA molecules into the ribosome A site.

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Analgesics

Class Summary

These agents can be used to relieve acute undifferentiated abdominal pain in patients presenting to the ED.

Morphine sulfate (Astramorph, Duramorph, MS Contin, MSIR, Oramorph)

 

Morphine sulfate is the drug of choice for analgesia because of its reliable and predictable effects, safety profile, and ease of reversibility with naloxone. Various intravenous doses are used; morphine sulfate is commonly titrated to the desired effect.

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Contributor Information and Disclosures
Author

Sandy Craig, MD Residency Program Director, Carolinas Medical Center; Associate Professor, Department of Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine

Sandy Craig, MD is a member of the following medical societies: Alpha Omega Alpha, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director for Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Eugene Hardin, MD, FAAEM, FACEP Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

William Lober, MD, MS Associate Professor, Health Informatics and Global Health, Schools of Medicine, Nursing, and Public Health, University of Washington

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References
  1. Polites SF, Mohamed MI, Habermann EB, et al. A simple algorithm reduces computed tomography use in the diagnosis of appendicitis in children. Surgery. 2014 Jun 19. [Medline].

  2. Douglas D. Algorithm cuts pediatric CT use in suspected appendicitis. Reuters Health Information. July 10, 2014. [Full Text].

  3. Yeh B. Evidence-based emergency medicine/rational clinical examination abstract. Does this adult patient have appendicitis?. Ann Emerg Med. 2008 Sep. 52(3):301-3. [Medline].

  4. Markle GB 4th. Heel-drop jarring test for appendicitis. Arch Surg. 1985 Feb. 120(2):243. [Medline].

  5. Thimsen DA, Tong GK, Gruenberg JC. Prospective evaluation of C-reactive protein in patients suspected to have acute appendicitis. Am Surg. 1989 Jul. 55(7):466-8. [Medline].

  6. de Carvalho BR, Diogo-Filho A, Fernandes C, Barra CB. [Leukocyte count, C reactive protein, alpha-1 acid glycoprotein and erythrocyte sedimentation rate in acute appendicitis]. Arq Gastroenterol. 2003 Jan-Mar. 40(1):25-30. [Medline].

  7. Albu E, Miller BM, Choi Y, et al. Diagnostic value of C-reactive protein in acute appendicitis. Dis Colon Rectum. 1994 Jan. 37(1):49-51. [Medline].

  8. Bolandparvaz S, Vasei M, Owji AA, Ata-Ee N, Amin A, Daneshbod Y, et al. Urinary 5-hydroxy indole acetic acid as a test for early diagnosis of acute appendicitis. Clin Biochem. 2004 Nov. 37(11):985-9. [Medline].

  9. Kim K, Kim YH, Kim SY, Kim S, Lee YJ, Kim KP, et al. Low-dose abdominal CT for evaluating suspected appendicitis. N Engl J Med. 2012 Apr 26. 366(17):1596-605. [Medline].

  10. Howell JM, Eddy OL, Lukens TW, Thiessen ME, Weingart SD, Decker WW. Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010 Jan. 55(1):71-116. [Medline].

  11. [Guideline] National Guideline Clearinghouse (NGC). Guideline summary: Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected appendicitis. National Guideline Clearinghouse (NGC), Rockville (MD). Available at http://guideline.gov/content.aspx?id=15598. Accessed: November 18, 2013.

  12. Barloon TJ, Brown BP, Abu-Yousef MM, Warnock N, Berbaum KS. Sonography of acute appendicitis in pregnancy. Abdom Imaging. 1995 Mar-Apr. 20(2):149-51. [Medline].

  13. Manterola C, Vial M, Moraga J, Astudillo P. Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011 Jan 19. 1:CD005660. [Medline].

  14. Karamanakos SN, Sdralis E, Panagiotopoulos S, Kehagias I. Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech. 2010 Apr. 20(2):119-24. [Medline].

  15. Niwa H, Hiramatsu T. A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst. World J Gastroenterol. 2008 Feb 28. 14(8):1293-5. [Medline]. [Full Text].

  16. Place RC. Acute urinary retention in a 9-year-old child: an atypical presentation of acute appendicitis. J Emerg Med. 2006 Aug. 31(2):173-5. [Medline].

  17. Oto A, Ernst RD, Mileski WJ, Nishino TK, Le O, Wolfe GC, et al. Localization of appendix with MDCT and influence of findings on choice of appendectomy incision. AJR Am J Roentgenol. 2006 Oct. 187(4):987-90. [Medline].

  18. Sedlak M, Wagner OJ, Wild B, Papagrigoriades S, Exadaktylos AK. Is there still a role for rectal examination in suspected appendicitis in adults?. Am J Emerg Med. 2008 Mar. 26(3):359-60. [Medline].

  19. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986 May. 15(5):557-64. [Medline].

  20. Schneider C, Kharbanda A, Bachur R. Evaluating appendicitis scoring systems using a prospective pediatric cohort. Ann Emerg Med. 2007 Jun. 49(6):778-84, 784.e1. [Medline].

  21. Schneider C, Kharbanda A, Bachur R. Evaluating appendicitis scoring systems using a prospective pediatric cohort. Ann Emerg Med. 2007 Jun. 49(6):778-84, 784.e1. [Medline].

  22. Migraine S, Atri M, Bret PM, Lough JO, Hinchey JE. Spontaneously resolving acute appendicitis: clinical and sonographic documentation. Radiology. 1997 Oct. 205(1):55-8. [Medline].

  23. Cobben LP, de Van Otterloo AM, Puylaert JB. Spontaneously resolving appendicitis: frequency and natural history in 60 patients. Radiology. 2000 May. 215(2):349-52. [Medline].

  24. Dueholm S, Bagi P, Bud M. Laboratory aid in the diagnosis of acute appendicitis. A blinded, prospective trial concerning diagnostic value of leukocyte count, neutrophil differential count, and C-reactive protein. Dis Colon Rectum. 1989 Oct. 32(10):855-9. [Medline].

  25. Gurleyik E, Gurleyik G, Unalmiser S. Accuracy of serum C-reactive protein measurements in diagnosis of acute appendicitis compared with surgeon's clinical impression. Dis Colon Rectum. 1995 Dec. 38(12):1270-4. [Medline].

  26. Shakhatreh HS. The accuracy of C-reactive protein in the diagnosis of acute appendicitis compared with that of clinical diagnosis. Med Arh. 2000. 54(2):109-10. [Medline].

  27. Asfar S, Safar H, Khoursheed M, Dashti H, al-Bader A. Would measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis?. J R Coll Surg Edinb. 2000 Feb. 45(1):21-4. [Medline].

  28. Erkasap S, Ates E, Ustuner Z, Sahin A, Yilmaz S, Yasar B, et al. Diagnostic value of interleukin-6 and C-reactive protein in acute appendicitis. Swiss Surg. 2000. 6(4):169-72. [Medline].

  29. Gronroos JM, Gronroos P. Leucocyte count and C-reactive protein in the diagnosis of acute appendicitis. Br J Surg. 1999 Apr. 86(4):501-4. [Medline].

  30. Ortega-Deballon P, Ruiz de Adana-Belbel JC, Hernandez-Matias A, Garcia-Septiem J, Moreno-Azcoita M. Usefulness of laboratory data in the management of right iliac fossa pain in adults. Dis Colon Rectum. 2008 Jul. 51(7):1093-9. [Medline].

  31. Gronroos JM. Is there a role for leukocyte and CRP measurements in the diagnosis of acute appendicitis in the elderly?. Maturitas. 1999 Mar 15. 31(3):255-8. [Medline].

  32. Yang HR, Wang YC, Chung PK, et al. Role of leukocyte count, neutrophil percentage, and C-reactive protein in the diagnosis of acute appendicitis in the elderly. Am Surg. 2005 Apr. 71(4):344-7. [Medline].

  33. Gronroos JM. Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children?. Acta Paediatr. 2001 Jun. 90(6):649-51. [Medline].

  34. Stefanutti G, Ghirardo V, Gamba P. Inflammatory markers for acute appendicitis in children: are they helpful?. J Pediatr Surg. 2007 May. 42(5):773-6. [Medline].

  35. Mohammed AA, Daghman NA, Aboud SM, Oshibi HO. The diagnostic value of C-reactive protein, white blood cell count and neutrophil percentage in childhood appendicitis. Saudi Med J. 2004 Sep. 25(9):1212-5. [Medline].

  36. Yang HR, Wang YC, Chung PK, Chen WK, Jeng LB, Chen RJ. Laboratory tests in patients with acute appendicitis. ANZ J Surg. 2006 Jan-Feb. 76(1-2):71-4. [Medline].

  37. Tundidor Bermudez AM, Amado Dieguez JA, Montes de Oca Mastrapa JL. [Urological manifestations of acute appendicitis]. Arch Esp Urol. 2005 Apr. 58(3):207-12. [Medline].

  38. Rao PM, Rhea JT, Rattner DW, et al. Introduction of appendiceal CT: impact on negative appendectomy and appendiceal perforation rates. Ann Surg. 1999 Mar. 229(3):344-9. [Medline].

  39. McGory ML, Zingmond DS, Nanayakkara D, Maggard MA, Ko CY. Negative appendectomy rate: influence of CT scans. Am Surg. 2005 Oct. 71(10):803-8. [Medline].

  40. Harswick C, Uyenishi AA, Kordick MF, Chan SB. Clinical guidelines, computed tomography scan, and negative appendectomies: a case series. Am J Emerg Med. 2006 Jan. 24(1):68-72. [Medline].

  41. Frei SP, Bond WF, Bazuro RK, Richardson DM, Sierzega GM, Reed JF. Appendicitis outcomes with increasing computed tomographic scanning. Am J Emerg Med. 2008 Jan. 26(1):39-44. [Medline].

  42. Pickhardt PJ, Lawrence EM, Pooler BD, Bruce RJ. Diagnostic performance of multidetector computed tomography for suspected acute appendicitis. Ann Intern Med. 2011 Jun 21. 154(12):789-96. [Medline].

  43. Kepner AM, Bacasnot JV, Stahlman BA. Intravenous contrast alone vs intravenous and oral contrast computed tomography for the diagnosis of appendicitis in adult ED patients. Am J Emerg Med. 2012 May 23. [Medline].

  44. Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. N Engl J Med. 2007 Nov 29. 357(22):2277-84. [Medline].

  45. Zilbert NR, Stamell EF, Ezon I, Schlager A, Ginsburg HB, Nadler EP. Management and outcomes for children with acute appendicitis differ by hospital type: areas for improvement at public hospitals. Clin Pediatr (Phila). 2009 Jun. 48(5):499-504. [Medline].

  46. Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, Schuh S, et al. US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Radiology. 2006 Oct. 241(1):83-94. [Medline].

  47. Boggs W. Ultrasound/MRI Strategy Diagnoses Appendicitis in Kids Without Radiation. Medscape Medical News. Available at http://www.medscape.com/viewarticle/821332. Accessed: March 12, 2014.

  48. Aspelund G, Fingeret A, Gross E, Kessler D, Keung C, Thirumoorthi A, et al. Ultrasonography/MRI Versus CT for Diagnosing Appendicitis. Pediatrics. 2014 Mar 3. [Medline].

  49. Cobben LP, Groot I, Haans L, Blickman JG, Puylaert J. MRI for clinically suspected appendicitis during pregnancy. AJR Am J Roentgenol. 2004 Sep. 183(3):671-5. [Medline].

  50. Repplinger MD, Levy JF, Peethumnongsin E, et al. Systematic review and meta-analysis of the accuracy of MRI to diagnose appendicitis in the general population. J Magn Reson Imaging. 2015 Dec 22. [Medline].

  51. Thieme ME, Leeuwenburgh MM, Valdehueza ZD, Bouman DE, de Bruin IG, Schreurs WH, et al. Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis. Eur Radiol. 2013 Oct 19. [Medline].

  52. Singer DD, Thode HC Jr, Singer AJ. Effects of pain severity and CT imaging on analgesia prescription in acute appendicitis. Am J Emerg Med. 2016 Jan. 34 (1):36-9. [Medline].

  53. Eriksson S, Granström L. Randomized controlled trial of appendicectomy versus antibiotic therapy for acute appendicitis. Br J Surg. 1995 Feb. 82(2):166-9. [Medline].

  54. Salminen P, Paajanen H, Rautio T, et al. Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial. JAMA. 2015 Jun 16. 313 (23):2340-8. [Medline].

  55. Bonadio W, Rebillot K, Ukwuoma O, Saracino C, Iskhakov A. Management of pediatric perforated appendicitis: comparing outcomes using early appendectomy vs solely medical management. Pediatr Infect Dis J. 2015 Dec 14. [Medline].

  56. Bickell NA, Aufses AH Jr, Rojas M, Bodian C. How time affects the risk of rupture in appendicitis. J Am Coll Surg. 2006 Mar. 202(3):401-6. [Medline].

  57. Abou-Nukta F, Bakhos C, Arroyo K, Koo Y, Martin J, Reinhold R, et al. Effects of delaying appendectomy for acute appendicitis for 12 to 24 hours. Arch Surg. 2006 May. 141(5):504-6; discussion 506-7. [Medline].

  58. Fair BA, Kubasiak JC, Janssen I, et al. The impact of operative timing on outcomes of appendicitis: a National Surgical Quality Improvement Project analysis. Am J Surg. 2015 Mar. 209 (3):498-502. [Medline].

  59. Boomer LA, Cooper JN, Anandalwar S, et al. Delaying appendectomy does not lead to higher rates of surgical site infections: a multi-institutional analysis of children with appendicitis. Ann Surg. 2015 Dec 16. [Medline].

  60. [Guideline] Korndorffer JR Jr, Fellinger E, Reed W. SAGES guideline for laparoscopic appendectomy. Surg Endosc. 2010 Apr. 24(4):757-61. [Medline]. [Full Text].

  61. Wilasrusmee C, Sukrat B, McEvoy M, Attia J, Thakkinstian A. Systematic review and meta-analysis of safety of laparoscopic versus open appendicectomy for suspected appendicitis in pregnancy. Br J Surg. 2012 Nov. 99(11):1470-8. [Medline].

  62. Liang MK, Lo HG, Marks JL. Stump appendicitis: a comprehensive review of literature. Am Surg. 2006 Feb. 72(2):162-6. [Medline].

  63. Barclay L. Ultrasound, CT Comparable to Detect Appendicitis in Children. Medscape Medical News. Available at http://www.medscape.com/viewarticle/817370. Accessed: December 9, 2013.

  64. Le J, Kurian J, Cohen HW, Weinberg G, Scheinfeld MH. Do clinical outcomes suffer during transition to an ultrasound-first paradigm for the evaluation of acute appendicitis in children?. AJR Am J Roentgenol. 2013 Dec. 201(6):1348-52. [Medline].

  65. Hurst AL, Olson D, Somme S, et al. Once-daily ceftriaxone plus metronidazole versus ertapenem and/or cefoxitin for pediatric appendicitis. J Pediatric Infect Dis Soc. 2015 Dec 24. [Medline].

 
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CT scan reveals an enlarged appendix with thickened walls, which do not fill with colonic contrast agent, lying adjacent to the right psoas muscle.
Sagittal graded compression transabdominal sonogram shows an acutely inflamed appendix. The tubular structure is noncompressible, lacks peristalsis, and measures greater than 6 mm in diameter. A thin rim of periappendiceal fluid is present.
Transverse graded compression transabdominal sonogram of an acutely inflamed appendix. Note the targetlike appearance due to thickened wall and surrounding loculated fluid collection.
Technetium-99m radionuclide scan of the abdomen shows focal uptake of labeled WBCs in the right lower quadrant consistent with acute appendicitis.
Perforated appendicitis.
Normal appendix; barium enema radiographic examination. A complete contrast-filled appendix is observed (arrows), which effectively excludes the diagnosis of appendicitis.
Table 1. MANTRELS Score
Characteristic Score
M = Migration of pain to the RLQ 1
A = Anorexia 1
N = Nausea and vomiting 1
T = Tenderness in RLQ 2
R = Rebound pain 1
E = Elevated temperature 1
L = Leukocytosis 2
S = Shift of WBCs to the left 1
Total 10
Source: Alvarado.[19]
RLQ = right lower quadrant; WBCs = white blood cells
Table 2. WBC Count and Likelihood of Appendicitis
WBC (× 10,000) Likelihood Ratio (95% CI)
4-7 0.10 (0-0.39)
7-9 0.52 (0-1.57)
9-11 0.29 (0-0.62)
11-13 2.8 (1.2-4.4)
13-15 1.7 (0-3.6)
15-17 2.8 (0-6.0)
17-19 3.5 (0-10)
19-22
Source: Dueholm et al.[24]
CI = confidence interval; WBC = white blood cell.
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