What does MANTRELS stand for?

Migration, Anorexia, Nausea, Tenderness RLQ, Rebound, Elevated temperature, Leukocytosis, Shift of left (neutrophils).

Alvarado Score (Appendicitis)

Medical context

Score clinical likelihood of acute appendicitis using the Alvarado (MANTRELS) criteria.

Surgical and trauma teams use this for operative planning, resuscitation, and perioperative risk framing.

This page explains the Alvarado formula, how to interpret the output, known limitations, and peer-reviewed references so you can verify results against primary sources and local protocols.

It is grouped under Surgery & Trauma because burn resuscitation, surgical risk, and fluids.

How to use this calculator

Enter the values requested by the Alvarado calculator using the units shown beside each field.
Review the calculated result and read the interpretation section before acting on the output.
Check limitations and references if the result will change management, dosing, or disposition.
Use the related calculators section when you need supporting values (for example electrolytes, weight, or complementary risk scores).

Calculator

Migration of pain to RLQ

Anorexia

Nausea / vomiting

RLQ tenderness

Rebound tenderness

Fever ≥37.3°C

Leukocytosis (WBC >10)

Left shift (neutrophilia)

Result

0 / 10

Appendicitis unlikely

Educational use only. Confirm results with clinical judgment, primary sources, and local protocols. Not a substitute for professional medical advice. Full disclaimer.

Formula

Symptoms, signs, and labs scored to a maximum of 10.

Interpretation

Low scores make appendicitis less likely; mid-range suggests observation/imaging; high scores support surgical evaluation.

Limitations

Imaging and clinical judgment remain essential; performance varies by population and sex.

Frequently asked questions

What does MANTRELS stand for?: Migration, Anorexia, Nausea, Tenderness RLQ, Rebound, Elevated temperature, Leukocytosis, Shift of left (neutrophils).
Is the Alvarado result enough to make a treatment decision?: No. Calculators support medical decision-making but do not replace examination, shared decision-making, institutional protocols, or consultant input when stakes are high.
Does Calcmedical store the values I type in?: Inputs are processed in your browser for this session. We do not ask for patient names or medical record numbers. See our privacy policy for hosting and analytics details.

References

Alvarado A. Ann Emerg Med.