Calculators & Tools

Pediatric Appendicitis Score (PAS)

Likelihood of acute appendicitis in a child with abdominal pain.

1 What is the Pediatric Appendicitis Score (PAS)?

The Pediatric Appendicitis Score (PAS) is a GI & Liver scoring tool used in paediatric practice. Likelihood of acute appendicitis in a child with abdominal pain. It scores 8 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in GI & Liver
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 8 criteria: Cough / percussion / hopping tenderness in RLQ; Right lower quadrant tenderness; Anorexia; Pyrexia ≥ 38 °C; Nausea or vomiting; Migration of pain to RLQ; Leucocytosis ≥ 10 000 /µL; Neutrophilia ≥ 7 500 /µL. Totals are then banded: any score - Low risk: pAS ≤3 - appendicitis unlikely. Consider discharge with review, or observation if the story is atypical; 4 points or more - Equivocal: pAS 4-6 - equivocal. Imaging (ultrasound first in children) and/or serial examination with surgical input; 7 points or more - High risk: pAS ≥7 - appendicitis likely. Surgical referral; many centres proceed without further imaging.
  • Total range 0-10.
  • Source: Samuel M. Pediatric appendicitis score. J Pediatr Surg 2002;37:877-81.

4 Frequently asked questions

How many criteria does the Pediatric Appendicitis Score (PAS) use?

8. They are Cough / percussion / hopping tenderness in RLQ; Right lower quadrant tenderness; Anorexia; Pyrexia ≥ 38 °C; Nausea or vomiting; Migration of pain to RLQ; and others.

What do the bands of the Pediatric Appendicitis Score (PAS) mean?

The total is interpreted as: any score - Low risk: pAS ≤3 - appendicitis unlikely. Consider discharge with review, or observation if the story is atypical; 4 points or more - Equivocal: pAS 4-6 - equivocal. Imaging (ultrasound first in children) and/or serial examination with surgical input; 7 points or more - High risk: pAS ≥7 - appendicitis likely. Surgical referral; many centres proceed without further imaging.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Total range 0-10.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.