Valentino’s Syndrome in a Child: Perforated Peptic Ulcer Mimicking Acute Appendicitis

Yıldız, Zeliha Akış; Ayyıldız, Hayriye Nihan

doi:10.12956/tjpd.2018.346

Cited by 2 publications

(5 citation statements)

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“…En otros casos, los rangos se encontraban dentro de parámetros de referencia. Los uroanálisis y otros exámenes resultaron normales [1][2][3][4][6][7][8][9][10][11][12][13]. En la anamnesis del caso expuesto, el dolor abdominal se describió como difuso y mal localizado; sin embargo, en la exploración física del paciente se encontraron signos indicativos de apendicitis aguda, y posteriormente de una peritonitis.…”

Section: Discussionunclassified

“…En otros casos revisados, el equipo médico tuvo dificultades similares de accesibilidad a tomografía, que llevaron igualmente a laparotomía exploratoria [1,[6][7][8][10][11][12][13], y en otros casos laparoscopía [2][3][4]9], según la condición clínica del paciente. Aparte, dos casos tuvieron acceso a tomografía computarizada, cuyos signos ayudaron al diagnóstico en un caso [3], mientras que no fue concluyente en otro [8].…”

Section: Discussionunclassified

“…En los casos revisados, 8 presentaron perforación de úlcera péptica a nivel duodenal anterior o retroperitoneal [1][2][3][7][8][9][10]13]. Sin embargo, 4 casos evidenciaron perforación de úlcera péptica a nivel prepilórico, en cara anterior de estómago [4,6,11,12], como en nuestro paciente. Esto nos permite deducir que la localización más frecuente de la perforación de úlcera péptica, cuya sintomatología simula a una apendicitis aguda está en el duodeno.…”

Section: Discussionunclassified

“…Se puede realizar un cierre simple con suturas intermitentes, con o sin omentoplastia; se puede introducir un tapón omental en la perforación con sutura posterior; y finalmente, un parche omental después de la técnica de Graham [1]. En la mayoría de casos reportados, las úlceras perforadas fueron manejadas con rafia primaria sin parche de Graham [1,6], mientras que otros rafia primaria y parche de Graham [2][3][4][7][8][9][10][11][12][13]. En nuestro paciente, se le practicó rafia primaria en dos planos sin parche de Graham.…”

Section: Discussionunclassified

“…En nuestro paciente, se le practicó rafia primaria en dos planos sin parche de Graham. Todos los pacientes de los estudios, incluido el nuestro, tuvieron evolución favorable en el postoperatorio, asociando antibioticoterapia, tamizaje de Helicobacter pylori seriado, protección gástrica y analgésicos no AINE, recibiendo el alta de acuerdo con el criterio del equipo médico en cada caso [1][2][3][4][6][7][8][9][10][11][12][13].…”

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Síndrome de Valentino: una causa no común de abdomen agudo. Reporte de un caso

Hurtado¹,

Ullaguari²,

Becerra³

et al. 2020

Rev Med HJCA

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BACKGROUND: Valentino’s syndrome is secondary to a perforated peptic ulcer, which could be located in the stomach or the duodenum, patients present with clinical features that suggest acute appendicitis, with localized peritonitis. There are few case reports about this syndrome worldwide and no one submitted in Ecuador. It is essential to transmit this clinical case for the knowledge of the medical- scientific community. CASE REPORT: A 63-year-old male patient came to the emergency department with abdominal pain, located in the right iliac fossa, that began 12 hours ago, associated to peritoneal irritation signs and hemodynamic decompensation; suggestive of peritonitis. An exploratory laparotomy was performed. EVOLUTION: During exploratory laparotomy, no inflammatory changes were identified in the appendix. After abdominal cavity exploration, a perforated gastric ulcer was found. Primary raffia was stitched in two planes, incidental appendectomy and lavage of the abdominal cavity were performed. The patient had a successful recovery; and was discharged after 7 days at hospitalization. CONCLUSION: The perforation of a peptic ulcer can generate right iliac fossa pain, simulating acute appendicitis due to its clinical similarity. The medical team should consider Valentino’s Syndrome as an important differential diagnosis during the evaluation of a patient that arrives to the emergency room with abdominal pain, suggestive of appendicitis. KEYWORDS: ABDOMINAL PAIN, ILIUM, APPENDICITIS, PEPTIC ULCER PERFORATION, ABDOMEN ACU-TE, PERITONITIS

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Section: Discussionunclassified

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Síndrome de Valentino: una causa no común de abdomen agudo. Reporte de un caso

Hurtado¹,

Ullaguari²,

Becerra³

et al. 2020

Rev Med HJCA

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A Cautionary Tale: Unveiling Valentino’s Syndrome

Mahajan¹,

Abdulmajeed²,

Aljafari³

et al. 2022

Cureus

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Introduction: In the emergency room, acute pain in the abdomen is one of the most common symptoms that patients present with, and it is a result of a myriad of causes, leading to an exhaustive differential diagnosis. A perforated peptic ulcer is a rare cause of acute right iliac fossa or lower quadrant abdominal pain. It causes leakage of gastrointestinal contents in the area, resulting in localized inflammation and pain that is clinically similar to acute appendicitis. This condition is known as Valentino's syndrome.Aim: This study aims to highlight clinical and radiological features for patients with Valentino's syndrome, improving diagnostic accuracy.Methods: The authors conducted a retrospective analysis of all diagnosed cases of Valentino's syndrome from multiple facilities within the same organization for the research study. A total of 14 nonsequential cases were gathered. The term "Valentino's syndrome" was used to search in the PubMed and Google Scholar databases for the review of literature, and only 17 cases were found and reviewed.Results: Of the 31 patients, 83.9% were male, with a mean age of 39 years. Of all patients who presented with abdominal pain, 25.8% had it in the lower right abdomen. Vomiting (38.7%), nausea (35.4%), fever (16.1%), and constipation were all associated symptoms (12.9%). All cases were clinically diagnosed as acute appendicitis. Many patients had elevated levels of white blood cells, neutrophils, and CRP. Computed tomography (CT) scan was used in 70.9% of the cases, followed by ultrasound (58%) and x-ray (45.1%), where pneumoperitoneum and duodenal perforations were common. Graham's patch was used in 48.3% of the cases, appendectomy was used in 16.1% of the cases, and conservative care was used in 19.3% of the cases. Most patients were given proton pump inhibitors and antibiotics for Helicobacter pylori.Conclusion: Timely diagnosis of Valentino's syndrome via CT imaging is critical because it leads to immediate perforation repair. Patients' mortality and morbidity may be reduced if they are aware of the condition and receive an accurate, rapid preoperative diagnosis.

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Valentino’s Syndrome in a Child: Perforated Peptic Ulcer Mimicking Acute Appendicitis

Cited by 2 publications

References 4 publications

Síndrome de Valentino: una causa no común de abdomen agudo. Reporte de un caso

Síndrome de Valentino: una causa no común de abdomen agudo. Reporte de un caso

A Cautionary Tale: Unveiling Valentino’s Syndrome

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