The purpose of the study is to compare the outcomes of surgical interventions for acute appendicitis with the values of the Alvarado score. We conducted the study on 572 patients that underwent surgical interventions for acute appendicitis. Retrospectively, based on the medical records, we calculated the MANTRELS score and compared the outcomes of the intervention with the values of the applied score. Almost one third of the patients with a MANTRELS score lower than 6 had negative appendectomies. These patients represent 60% of the total cases of negative appendectomies, while in the case of patients with a high score around 2% had negative appendectomies. We concluded that using this scoring system to assess the need of immediate surgical intervention is important and can increase the rate of positive diagnosis mainly by limiting the number of unnecessary interventions.

Vesicoureteral reflux is characterized by the retrograde flow of urine from the bladder to the kidneys. Vesicoureteral reflux may be associated with urinary tract infection, hydronephrosis, and abnormal kidney development (renal dysplasia). Hydronephrosis - literally “water inside the kidney” - refers to distension and dilatation of the renal pelvis and calyces, usually caused by obstruction of the free flow of urine from the kidney. Untreated, it leads to progressive atrophy of the kidney. In cases of hydroureteronephrosis, there is distention of both the ureter and the renal pelvis and ureteres. However, in the current era, hydronephrosis that is evident on fetal ultrasonography often heralds a ureteral abnormality. Hydronephrosis is defined as dilatation of the renal pelvis and/or calyces. Vesicoureteral reflux may present before birth as prenatal hydronephrosis, an abnormal widening of the ureter or with a urinary tract infection or acute pyelonephritis. The authors present a case of bilateral VUR of IVth grade associated with congenital hydronephrosis of IIIrd grade, diagnosed before birth with bilateral hydronephrosis, and taken into evidence at 2 months when he was first diagnosed with urinary tract infection. Positive diagnosis was facilitated by laboratory investigations (urine analysis, urine culture, voiding cystourethrography, static renal scintigraphy).

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