Case Report: Suspected Valentino’s Syndrome mimicking acute appendicitis: a case report and literature review

<ns3:p>Introduction Valentino’s Syndrome is a rare affliction caused by the perforation of a peptic ulcer which simulates deviously a picture of acute appendicitis. The diagnosis of this condition is not simple (often intraoperative) and requires a high degree of suspicion. Case presentation A 90-year-old man arrived at the Emergency Room with abdominal pain mainly localized in the right iliac fossa (Blumberg +, McBurney +). The patient had a history of previous perforated peptic ulcer treated with surgery. A diagnosis of suspected perforated acute appendicitis was made based on clinical and radiological findings and the patient underwent urgent surgical intervention. Laparoscopic exploration revealed a picture of diffuse choleperitonitis due to a probable perforation of a duodenal ulcer. Considering the patient’s age and the severity of the clinical and surgical picture, characterized by the presence of indissociable intra-abdominal adhesions, it was decided to forgo further surgical procedures, except drainage of the abdominal cavity and palliative medical treatment, due to a poor prognosis. Conclusion This syndrome, although very rare, should always be suspected in cases of right iliac fossa pain in the presence of certain risk factors for perforated peptic ulcer. Patient’s ethnicity: Italian.</ns3:p>