Clinical diagnosis 

Symptoms 

RUQ

RUQ pain 

nausea/ vomiting 

perforation - severe abdominal pain, fever 

Signs 

mcborney point : ASIS - umbilicus - lateral 1/3, point of maximal tenderness 

Rebound tenderness - iritation of peritoneum - find a tenderness point, press down a few seconds - suddenly release - 

Rovsign sign - left lower quadrant - palpate tender 

obturator sign - flex right knee , internal rotate the hip 

Score 

AVARALDO SCORE 

Investigations 

normal WCC does not exclude appendicitis