Abstract

The most common cause of acute abdomen in children is appendicitis. However, in cases when the appendix is

observed normally during surgery, other surgical causes should be considered. Rarely, in the differential diagnosis

of right lower quadrant (RLQ) pain, gastric or duodenal ulcer perforation, defined as Valentino Syndrome, should be

considered and evaluated for possible pathology. In this case report, we aimed to discuss a case of unusual gastric

perforation that presented with symptoms and signs suggestive of appendicitis. Free air was not identified on plain

abdominal x-ray, and also no specific finding was found on ultrasonography. The appendix was normal during surgery.

There was plenty of serous fluid in the right lower quadrant. When fibrin was observed in upper quadrants, the incision

was expanded and it turned out to be a gastric perforation and was repaired. In cases with peritonitis findings in the

examination of the abdomen, even though the appendix is normal, it is very important to evaluate all intraabdominal

organs in terms of other diagnoses.

Keywords: Gastric perforation, Pediatric acute abdomen

References

  1. 1. Yu J, Fulcher AS, Turner MA, Halvorsen RA. Helical CT evaluation
  2. of acute right lower quadrant pain: part I, common mimics of
  3. appendicitis. AJR Am J Roentgenol 2005;184: 1136–42.
  4. 2. Wijegoonewaredene SI, Stein J, Cooke D, Tien A. Valentino’s
  5. syndrome a perforated peptic ulcer mimicking acute appendicitis.
  6. BMJ Case Rep 2012; 2012.
  7. 3. Valentino loses battle with death: Greatest of screen lovers fought
  8. valiantly for life. Plattsburgh Sentinel 1926;1.
  9. 4. Ramírez-Ramírez MM, Villanueva-Saenz E. Valentino’s syndrome.
  10. Perforated peptic ulcer with unusual clinical presentation. Rev
  11. Gastroenterol Mex 2016;81:225-6.
  12. 5. Hussain K, Munir A, Wahla MS, Masood J. Valentino’s syndrome:
  13. Perforated peptic ulcer mimicking acute appendicitis managed
  14. through rutherford morrison incision. J Coll Physicians Surg Pak
  15. 2016;26:727-8.
  16. 6. Amann C, Austin A, Rudinsky S. Valentino’s syndrome: A lifethreatening
  17. mimic of acute appendicitis. Clin Pract Cases Emerg
  18. Med 2016;1: 44-6.

Copyright and license

How to cite

1.
Akış Yıldız Z. Valentino’s Syndrome in a Child: Perforated Peptic Ulcer Mimicking Acute Appendicitis. Turk J Pediatr Dis [Internet]. 2018 Dec. 30 [cited 2025 May 24];12(4):287-8. Available from: https://turkjpediatrdis.org/article/view/500