A Rare Clinical Condition Mimicking Acute Appendicitis: Valentino Syndrome

Yıl 2025, Cilt: 52 Sayı: 4, 899 - 902, 12.12.2025

Özgür Genç , Yusuf Emre Altundal

https://doi.org/10.5798/dicletip.1841283

Öz

Objective: Valentino syndrome is a rare clinical entity that mimics acute appendicitis due to the retroperitoneal spread of a duodenal ulcer perforation. We present a case diagnosed preoperatively and treated laparoscopically.
Methods: A 51-year-old man presented with acute abdominal pain radiating from the epigastrium to the right lower quadrant. Physical examination revealed upper-quadrant tenderness and rebound. Laboratory testing showed a mild elevation in C-reactive protein (4.1 mg/L).
Results: Contrast-enhanced CT demonstrated intramural gas in the gastric antrum, inflammatory stranding within the periduodenal fat planes, free air anterior to the left hepatic lobe, and a reactively thickened appendix. A preoperative diagnosis of “Valentino appendicitis” was made. Laparoscopy confirmed a prepyloric perforation, which was repaired using a Graham patch. Appendectomy was not performed.
Conclusion: Valentino syndrome can be recognized preoperatively through careful clinical and radiologic assessment.

Anahtar Kelimeler

Valentino syndrome , duodenal ulcer perforation , acute appendicitis; preoperative diagnosis; laparoscopic surgery

Akut Apandisiti Taklit Eden Nadir Bir Klinik Durum: Valentino Sendromu

Öz

Amaç: Valentino sendromu, duodenal ülser perforasyonunun retroperitoneal yayılımı sonucu akut apandisiti taklit eden nadir bir klinik durumdur. Bu çalışmada preoperatif tanı konulup laparoskopik tedavi edilen bir olgu sunulmaktadır.
Yöntemler: Elli bir yaşında erkek hasta, epigastriumdan sağ alt kadrana yayılan akut karın ağrısı ile başvurdu. Fizik muayenede üst kadranda hassasiyet ve rebound, laboratuvar tetkiklerinde hafif CRP yüksekliği (4.1 mg/L) izlendi.
Bulgular: Kontrastlı BT'de gastrik antrumda intramural hava, periduodenal yağlı planlarda inflamasyon, sol hepatik lob anteriorunda serbest hava ve reaktif olarak kalınlığı artmış apendiks saptandı. Preoperatif olarak "Valentino apandisiti" tanısı konuldu. Laparoskopide prepilörik perforasyon doğrulandı ve Graham patch ile onarıldı. Apendektomi yapılmadı.
Sonuç: Valentino sendromu, dikkatli klinik ve radyolojik değerlendirme ile preoperatif olarak tanınabilir; bu sayede apendiks-koruyucu cerrahi uygulanabilir.

Anahtar Kelimeler

Valentino sendromu , duodenal ülser perforasyonu , akut apandisit , preoperatif tanı , laparoskopik cerrahi

Kaynakça

• 1.Wang HP, Su WC. Images in clinical medicine:veiled right kidney sign in a patient with Valentino’ssyndrome. N Engl J Med. 2006; 354: e9.
• 2.Wijegoonewardene SI, Stein J, Cooke D, Tien A.Valentino’s syndrome: a perforated peptic ulcermimicking acute appendicitis. BMJ Case Rep. 2012;2012: bcr0320126015.
• 3.Mahajan P, Abdalla M, Purayil N. First report ofpreoperative imaging diagnosis of a surgicallyconfirmed case of Valentino’s syndrome. J ClinImaging Sci. 2014; 4: 28.
• 4.Rodrigo VEU, Silva GPUP, Jayasinghe DSH, et al.Valentino’s syndrome: a rare and lethal differentialdiagnosis for acute appendicitis. SAGE Open MedCase Rep. 2022; 10: 2050313X2211320.
• 5.Luna-Guerrero CE. An unusual cause of abdominalpain: Valentino’s syndrome. A case report. Jpn JGastroenterol Hepatol. 2020; 4: 1-3.
• 6.Amann CJ, Austin AL, Rudinsky SL. Valentino’ssyndrome: a life-threatening mimic of acuteappendicitis. Clin Pract Cases Emerg Med. 2017; 1:44-6.
• 7.Machaku D, Suleman M, Mduma E, et al.Valentino’s syndrome: a bizarre clinicalpresentation. J Surg Case Rep. 2023; 2023: rjad035.
• 8.Karthik G, Naga B, Naik A. Valentino syndrome:retroperitoneal duodenal ulcer mimickingappendicitis. J Adv Clin Res Insights. 2020; 7: 55-8.
• 9.Mahajan PS, Abdulmajeed H, Aljafari A, et al. Acautionary tale: unveiling Valentino’s syndrome.Cureus. 2022; 14: e23067.