Valentino's syndrome: Simulation of acute appendicitis in the context of peptic ulcer perforation. Case report and literature review. (April 2023)

• Record Type: Journal Article
• Authors: Villamil-Angulo, Carlos José; Pérez Calvo, Daniela; Villamil Castro, Nathalia Andrea; Rey Chaves, Carlos Eduardo; Conde, Danny
• Is Part Of: International journal of surgery case reports. Volume 105(2023)
• Publication Date: 2023-04
• Subjects: Acute abdomen -- Appendicitis -- Valentino's syndrome -- Peptic ulcer -- Surgery -- Laparoscopy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2023.108064
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: Abdominal pain (AP) is one of the main reasons for consultation in the emergency department worldwide. The causes of AP are gathered in a broad group of pathologies whose incidence and prevalence vary according to various factors. The great importance of an adequate approach to AP lies in ruling out or confirming the presence of acute abdomen that requires emergency surgical management. Valentino's Syndrome (VS) simulates the clinical manifestations of acute appendicitis whose origin is the perforation of a peptic ulcer. This is an infrequent entity, with very few reports in the literature, this being the second case reported in Colombia. Case presentation: We present a case of VS in a 59-year-old male patient who was admitted to the emergency department with 3 days of pain in the right iliac fossa that met the diagnostic criteria for acute appendicitis. However, upon surgical exploration, it was determined that the cause was secondary to peptic ulcer perforation (PPU). Discussion: PPU is one of the most infrequent complications of the disease, occurring in close to 10 % of cases, and is considered a surgical emergency. Minimally invasive surgery provides a significant benefit over open surgery, outcomes that directly lead to decreased healthcare costs and increased patient satisfaction. Conclusion: PPU represents a diagnostic challenge due to the variability of the symptoms and clinical features. Laparoscopic approach fulfills diagnostic and therapeutic roles with lesser morbidity and mortality rates, which is why it should be standardized. Malignancy should be ruled out in all cases. Highlights: Perforated peptic ulcer disease represents a diagnostic challenge due to the variability of the symptoms and clinical features. PPU should be suspected in patients with acute abdomen who had previously presented with a similar clinical onset and suspected cases of appendicitis. Laparoscopic approach should be standardized due to the fact that it fulfills diagnostic and therapeutic roles with lesser rates of morbidity and mortality.