Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool

Digestive System

Choose the relevant clinical signs you want to include in the calculation of posttest probabilities. The strongest signs are listed the highest.


2Migration of pain
3Colic pain
4Abdominal pain
6Radiating pain

Clinical signs

12Bowel sounds increased
13Psoas sign
14Bowel sound decreased
15Rebound tenderness
16Murphy's sign
17Abdominal Mass
18Right upper quadrant pain
19Right lower quadrant pain

To further investigations

Select the conditions you want to compare

Pretest probabilities will be calculated based on averages from relevant studies.

 Select or deselect all boxes

Acute abdominal pain
Acute abdominal pain
Acute abdominal pain
Acute abdominal pain
Acute abdominal pain

Sources used:

1.David G. Bundy et al. Does This Child Have Appendicitis? JAMA. 2007 Jul 25; 298(4): 438–451.
2.Trowbridge RL et al. Does This Patient Have Acute Cholecystitis? JAMA, January 1, 2003—Vol 289, No. 1 80-86
3.Bohner H et al. Simple data from history and physical examination help to exclude bowel obstruction and to avoid radiographic studies in patients with acute abdominal pain. Eur J Surg. 1998 Oct;164(10):777-84
4.Wilkins T et al. Diagnosis and Management of Acute Diverticulitis. Am Fam Physician. 2013 May 1;87(9):612-620
5.Abraham S et al. Surgical and Nonsurgical Management of Gallstones. Am Fam Physician. 2014 May 15;89(10):795-802
6.Wagner JM et al. Does This Patient Have Appendicitis? JAMA. 1996;276(19):1589-1594
7.Hardin M et al. Acute Appendicitis: Review and Update. Am Fam Physician. 1999 Nov 1;60(7):2027-2034
8.Nshuti R et al. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath academic hospital. Int J Emerg Med. 2014; 7: 12
9.Lamture YR et al. The role of rebound tenderness in acute appendicitis and appendicular perforation. Int Surg J. 2017 Feb;4(2):725-727
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15.Toorenvliet BR et al. Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis. World J Surg 34(10):2278, October 2010
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21.Shea JA et al. Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. Arch Intern Med. 1994;154(22):2573–2581
22.Saaiq M et al. Diagnostic Accuracy of Leukocytosis in Prediction of Acute Appendicitis. Journal of the College of Physicians and Surgeons Pakistan 2014, Vol. 24 (1): 67-69
23.Dahmardehei M et al. Diagnostic Value of Leukocytosis, ESR and CRP in Patients with Suspected Acute Appendicitis. Zahedan J Res Med Sci 2013 Jul; 15(7): 59-63
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25.Chou YH et al. Sonography of acute right side colonic diverticulitis. Am J Surg. 2001 Feb;181(2):122-7
26.Ripolles T et al. The role of ultrasound in the diagnosis, management and evolutive prognosis of acute left-sided colonic diverticulitis: a review of 208 patients. Eur Radiol 2003; 13:2587–2595
27.Parente F et al. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Ailment Pharmacol Ther 2003; 18:1009–1016
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29.Kola S et al. Role of Ultrasonography in the diagnosis of the gallstones. Radiology 2013;4(10)
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32.Stefánsson R et al. Diverticulitis of the sigmoid colon. Acta Radiologica (1997) 38:2, 313-319
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34.Cervellin G et al. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016 Oct; 4(19): 362
35.Caporale N et al. Acute abdominal pain in the emergency department of a university hospital in Italy. United European Gastroenterology Journal 2016, Vol. 4(2) 297–304