European Journal of Molecular & Clinical Medicine

Abstract

IMPORTANCE: Valentino's syndrome is caused by a peptic ulcer perforation in which stomach contents leak and accumulates in the iliac fossa on right side, causing focal inflammation and discomfort in the right lower quadrant mimicking appendicitis. It is a rare case with only a few cases recorded in the review of literature.
OBJECTIVE: This study aims to discuss an unusual clinical presentation of a rare case of Valentino syndrome and about how the initial diagnosis of acute appendicitis was diagnosed to a case of perforated peptic ulcer with the help of CECT Abdopelvis and USG.
CASE PRESENTATION:  A 25/male who presented with pain in the right inferior quadrant for 3 days associated with  vomiting and fever with positive Mc Burney and Rovsing sign on examination was diagnosed clinically as acute appendicitis. USG showed duodenal perforation with perforation site sealed off by omentum. On CECT Abdomen, pneumoperitoneum was noted but the site of the perforation was not found. Intraoperatively, first part of duodenum showed a sealed off perforation without any perforation at other site. Patient was diagnosed as a case of Valentino syndrome.
CONCLUSION: Clinicians must be aware that though unusual, perforated peptic ulcer can present as a differential diagnosis for right iliac fossa pain. For a diagnosis, a strong index of suspicion and a proper radiographic assessment is required. If a perforated peptic ulcer is not treated promptly, it can progress to sepsis, multiorgan failure, and death.