The purpose of the work is to estimate, analysing epidemical, clinical and laboratory parameters, criteria that could more easily orientate for a correct diagnosis of acute appendicitis, selecting in this way some guide parameters.

Retrospectively a casuistry including 98 patients surgically treated, with diagnosis before the surgical operation of acute appendicitis, has been analysed. Before surgical operation, a correct diagnosis has been formulated for 92 patients.

The general symptoms have been estimated, such as nausea and vomit, associated to the painful symptomatology, the time from the first observation, to the moment of the surgical indication, the clinical objectivity, the corporeal temperature and leukocytosis count.

The Author considers the incidence of the main, clinical signs and symptoms in cases of their observation, they are confirmed by the intra and post-operative check, and they propose the use of a nosographic index assigning to every sign or symptom a different numerical value, in relation to clinical importance, in order to furmulate a correct diagnosis, and to avoid a late surgical treatment of gangrenous or perforated appendicitis, loaded with a larger morbidity, in vain treated with medical therapy. . The proposed scoring system, while further external evaluations remain necessary and useful, has the advantage, compared to other proposed and used scoring systems, such as the Alvarado score, of referring to a reduced number of elements to evaluate, among which only three objective signs, such as vomiting, closed bowel, positive Blumberg sign and two paraclinical signs, such as temperature and leukocytosis with neutrophilia. Finally, the patient’s age is added. The minimum achievable score was indicated as
highly suspicious of acute phlegmonous appendicitis and therefore sufficient to indicate surgery, that of 60 points.

Keywords
Acute appendicitis, Clinical diagnosis, Surgical indications, Medical treatment, Differential diagnosis