MDCalc

RIPASA Score for Acute Appendicitis

Diagnoses appendicitis with lab values and clinical findings, especially for Asian populations.

Demographic Information

Sex
Age
Foreign national
See Pearls/Pitfalls for clarification

Symtoms

Right iliac fossa (RIF) pain
Pain migration to RIF
Anorexia
Nausea & vomiting
Duration of symptoms

Signs

RIF tenderness
Guarding
Rebound tenderness
Rovsing sign
Temperature between 37°C and 39°C

Labs

Elevated white blood cell count
Negative urine analysis (abscence of blood, WBCs, bacteria)

Result:

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Advice

In settings where advanced imaging is used more liberally, the performance of the RIPASA Score is unclear, and no study has yet assessed its impact when applied clinically.

Management

We are unaware of validated management algorithms using the RIPASA Score.

Critical Actions

The RIPASA Score integrates and thus requires a number of laboratory test results and historical features, and while accuracy is high in initial studies, a larger more rigorous validation and/or implementation study would be very useful.