Calc Function

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    Patent Pending

    Pediatric Appendicitis Score (PAS)

    Predicts appendicitis in children.
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    BEFORE USE

    Use for patients 3-18 years of age.

    When to Use
    Pearls/Pitfalls
    Why Use
    About the Creator
    Dr. Madan Samuel
    Content Contributors
    • Jamie Lovell, MD

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    For patients who are not low risk, next steps include NPO status, IV fluids, analgesia, and imaging or surgical consultation.

    Management

    Low Risk PAS (<4)

    • Low likelihood of acute appendicitis, and likely do not warrant imaging.
    • The score has a higher negative predictive value (95%) in the absence of RLQ pain, pain with walking/jumping or coughing, and an ANC <6,750.
    • Consider other causes of acute abdominal pain.

    Equivocal PAS (4-6)

    • Imaging can be helpful for this subgroup of patients, preferably ultrasound or MRI for pediatric patients.
    • Surgical consults are warranted for patients with equivocal scores and imaging where the appendix cannot be visualized.

    High Risk PAS (>6)

    • Surgical consult is warranted for these patients.
    • Imaging may still be pursued, but patients should only undergo ultrasound prior to a surgical consult.

    Critical Actions

    Patients in the low risk group according to the PAS do not have a zero risk. Use clinical discretion if imaging or surgical consult may aid in diagnosis.

    Content Contributors
    • Jamie Lovell, MD