Resumo

ZULUAGA-ARBELAEZ, Nicolás; URIBE-CASTANO, Simón  e  MACHADO-RIVERA, Faber Albeiro. Valentino's syndrome: perforated peptic ulcer mimicking acute appendicitis. CES Med. [online]. 2018, vol.32, n.1, pp.74-78. ISSN 0120-8705.  https://doi.org/10.21615/cesmedicina.32.1.9.

Abdominal pain can have multiple etiologies, and the location of it usually guides us to the approach of certain differential diagnoses. We present a case of a 38 years old patient who presented with a rare cause of right lower quadrant pain, a perforated gastric ulcer that masqueraded clinically as appendicitis. Therefore, a laparoscopic intervention was performed to do the consecutively appendectomy. However, during the procedure no inflammatory changes were observed in the appendix that support the initial clinical suspicion. Thus, an exhaustive abdominal examination was performed finding a perforated gastric ulcer; the culprit of this atypical clinical picture. Then, the patient was treated with an appropriate ulcerorrhaphy with excellent results. In this case, gastric and duodenal contents traveled across the parietocolic gutter, accumulating in the low right quadrant. This produced a focal peritonitis in right iliac fossa and clinical picture compatible with appendicitis, or also known as Valentino's syndrome. This demonstrates the importance of including perforated gastric ulcer in the differential diagnosis of right lower quadrant pain especially in those patients with peritoneal signs.

Palavras-chave : Abdominal pain; Appendicitis; Peptic ulcer; Valentino syndrome.

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