BMJ Case Reports 2012; doi:10.1136/bcr.03.2012.6015
  • Rare disease

Valentino’s syndrome a perforated peptic ulcer mimicking acute appendicitis

  1. Alan Tien
  1. Acute Surgical Unit, Department of Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia
  1. Correspondence to Dr Sandeep Indika Wijegoonewardene, indika1000{at}


The authors present a case of a 30-year-old female who presented with symptoms and signs suggestive of appendicitis accompanied by elevated inflammatory markers. The patient was consented and taken to theatre for laparoscopic apendicectomy. At operation, the appendix was found to be normal but with surrounding turbid fluid in the right paracolic gutter and subhepatic space. On further inspection, a perforated pre pyloric ulcer was discovered. This was managed laparoscopically with a peritoneal lavage and falciform ligament patch repair. The patient made a good recovery and was discharged 2 days later. At 6 week follow-up the patient had an upper gastrointestinal (GI) endoscopy which showed complete healing of the ulcer. At 6 week follow-up the patient had an upper GI endoscopy which showed complete healing of the ulcer.


  • Competing interests None.

  • Patient consent Obtained.

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