Raja Isteri Pengiran Anak Saleha Appendicitis Diagnostic Score
The RIPASA (Raja Isteri Pengiran Anak Saleha) score is a clinical diagnostic tool used to assess the likelihood of acute appendicitis. It was developed specifically for Asian populations and has shown high sensitivity and specificity in diagnosing appendicitis.
RIPASA Score Calculator
Raja Isteri Pengiran Anak Saleha Appendicitis Diagnostic Score
About RIPASA Score
The RIPASA (Raja Isteri Pengiran Anak Saleha) score is a clinical diagnostic tool used to assess the likelihood of acute appendicitis. It was developed specifically for Asian populations and has shown high sensitivity and specificity in diagnosing appendicitis.
Clinical Importance
Acute appendicitis is a common surgical emergency, but diagnosis can be challenging. The RIPASA score helps standardize the assessment of patients with suspected appendicitis, potentially reducing negative appendectomy rates and improving diagnostic accuracy.
RIPASA Score Components
The score evaluates multiple clinical parameters, each assigned specific points:
| Parameter | Points |
|---|---|
| Male gender | 1.0 |
| Female gender | 0.5 |
| Age < 40 years | 1.0 |
| Age ≥ 40 years | 0.5 |
| Right iliac fossa pain | 0.5 |
| Pain migration to right iliac fossa | 0.5 |
| Anorexia | 1.0 |
| Nausea and vomiting | 1.0 |
| Duration of symptoms < 48 hours | 1.0 |
| Duration of symptoms ≥ 48 hours | 0.5 |
| Right iliac fossa tenderness | 1.0 |
| Rebound tenderness | 1.0 |
| Rovsing’s sign | 2.0 |
| Elevated temperature (>37°C) | 1.0 |
| Guarding | 2.0 |
| White blood cell count > 10,000/μL | 1.0 |
| Negative urinalysis | 1.0 |
Interpretation
The RIPASA score ranges from 0 to 16.5, with higher scores indicating greater likelihood of appendicitis:
Scores between 5.0 and 7.5 are considered equivocal and may require further investigation or observation.
Note: This calculator is for educational purposes only. Clinical decisions should not be based solely on this tool. Always consult with healthcare professionals for patient management.
RIPASA Score Calculator
RIPASA Score Result
Component Scores
Understanding the Criteria
Right Iliac Fossa Pain: Pain localized to the right lower quadrant of the abdomen.
Pain Migration: Pain that starts elsewhere (often periumbilical) and moves to the right lower quadrant.
Anorexia: Loss of appetite, a common symptom in appendicitis.
Nausea and Vomiting: Common gastrointestinal symptoms in appendicitis.
Right Iliac Fossa Tenderness: Pain on palpation of the right lower quadrant.
Rebound Tenderness: Pain that increases when pressure is released, suggesting peritoneal inflammation.
Rovsing’s Sign: Pain in the right lower quadrant when pressure is applied to the left lower quadrant.
Guarding: Involuntary muscle contraction of the abdominal wall when touched.
