Department of Physical Education and Sports Sciences of Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece.
School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Am J Case Rep. 2020 Jul 2;21:e922647. doi: 10.12659/AJCR.922647.
BACKGROUND In the emergency department pain in the right lower quadrant is a frequent finding and is related to a wide variety of diseases, the most common of which is acute appendicitis. An unusual presentation of pain in the right iliac fossa is due to perforation of a duodenal peptic ulcer. The fluid that originates from the perforated ulcer moves through the paracolic sulcus to the right iliac fossa and causes irritation of the peritoneum and even chemical peri-appendicitis, thereby imitating all the usual causes of pain in the right lower quadrant. This condition is known as Valentino's syndrome, named after the Italian actor Rudolph Valentino. CASE REPORT The aim of this case report was to review the current published literature regarding Valentino's syndrome and report on a case involving a 51-year-old male who was admitted to our surgical department with right lower quadrant pain and suspicion of acute appendicitis. An exploratory laparotomy was performed, from which a retroperitoneal perforation of a duodenal ulcer was found; suture closure was then applied. The patient's postoperative course was uncomplicated, and he was discharged 9 days after the operation. CONCLUSIONS Surgeons should be alert for this rare condition imitating acute appendicitis, and the differential diagnosis of right lower quadrant pain should include peptic ulcer perforation.
在急诊科，右下象限疼痛是一种常见的表现，与多种疾病有关，其中最常见的是急性阑尾炎。右髂窝疼痛的一种不常见表现是由于十二指肠溃疡穿孔。源自穿孔的溃疡的液体通过结肠旁沟移动到右髂窝，引起腹膜刺激，甚至化学性阑尾周围炎，从而模仿右下象限疼痛的所有常见原因。这种情况被称为 Valentino 综合征，以意大利演员鲁道夫·瓦伦蒂诺（Rudolph Valentino）的名字命名。
本病例报告旨在回顾当前关于 Valentino 综合征的已发表文献，并报告一例 51 岁男性患者，因右下象限疼痛和疑似急性阑尾炎而被收入我院外科。进行了剖腹探查术，发现十二指肠溃疡的腹膜后穿孔；随后进行了缝合闭合。患者术后恢复顺利，术后 9 天出院。
外科医生应警惕这种罕见的模仿急性阑尾炎的情况，右下象限疼痛的鉴别诊断应包括溃疡穿孔。
