Introduction: Despite advanced imaging techniques and several validated clinical prediction rules, correctly diagnosing a patient with acute appendicitis remains challenging. The AIR score and the AAS score 6 seem currently to be the best performing clinical prediction scores and have the highest discriminating power in adults with suspected acute appendicitis. The Laparoscopic Appendicitis Score 7 (LAPP) is an easily applicable score that can be used by surgeons to evaluate the appendix during diagnostic laparoscopy.

Scope: The aim is to verify whether an increase in the AAS score corresponds to a worse intraoperative picture certified by the postoperative questionnaire.

Materials and Method: 157 patients with abdominal pain localized in the right iliac fossa were observed. 102 patients (65%) were hospitalized with the diagnosis of acute appendicitis. Based on the AAS we divided the hospitalized patients into 3 groups.

Results: In our case series we have shown that an increase in the AAS score always corresponds to a worse intraoperative picture.