Valentino Syndrome: A Surgical Emergency with Appendicitis-Like Presentation

Valentino Syndrome is a rare but potentially serious medical condition.In this article, we discuss the case of a 39-year-old chronic smoker who presented with right iliac fossa pain evolving for 15 days. The symptoms worsened four days before admission with the onset of generalized abdominal pain accentuated in the epigastric region, with a history of recent NSAID intake for right iliac fossa pain. A chest X-ray revealed pneumoperitoneum, with a CT scan confirming hydropneumoperitoneum. The patient was urgently taken to the operating room, where exploration revealed a large amount of purulent peritoneal effusion, a 1 cm perforation in the pylorus with soft edges, subhepatic and interloop adhesions at the Douglas pouch, cecum, and terminal ileum, a gastrocolic fistula between the cecum and 40 cm of the colon, sealed by the greater omentum, and a perforated and digested appendix. The postoperative course was uneventful, and the patient was discharged on postoperative day 5 after drain removal and incident-free feeding.