Sum the MANTRELS appendicitis points: RLQ and leukocytosis count 2, the rest count 1.
| Score | – |
Use this calculator to add the eight Alvarado (MANTRELS) items. Migration of pain, anorexia, nausea or vomiting, rebound, fever, and left shift each add 1 point. Right-lower-quadrant tenderness and leukocytosis each add 2. The maximum is 10.
This is a clinical screen, not a CT, ultrasound, or decision to operate. Thresholds vary by protocol.
Pain migration: Pain moved toward the right lower quadrant.
Anorexia: Loss of appetite.
Nausea: Nausea or vomiting.
RLQ tenderness: Tenderness in the right lower quadrant (2 points).
Rebound: Rebound tenderness.
Fever: Fever.
Leukocytosis: Raised white-cell count (2 points).
Left shift: Neutrophil left shift.
Score: Sum of the eight items.
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