Mahajan Parag S, Abdulmajeed Hatem, Aljafari Abdulmalek, Kolleri Jouhar J, Dawdi Salahaldeen A, Mohammed Hussain
Clinical Imaging, Hamad Medical Corporation, Doha, QAT.
Medical School, Saint James School of Medicine, Arnos Vale, VCT.
Cureus. 2022 Feb 27;14(2):e22667. doi: 10.7759/cureus.22667. eCollection 2022 Feb.
In the emergency room, acute pain in the abdomen is one of the most common symptoms that patients present with, and it is a result of a myriad of causes, leading to an exhaustive differential diagnosis. A perforated peptic ulcer is a rare cause of acute right iliac fossa or lower quadrant abdominal pain. It causes leakage of gastrointestinal contents in the area, resulting in localized inflammation and pain that is clinically similar to acute appendicitis. This condition is known as Valentino's syndrome.
This study aims to highlight clinical and radiological features for patients with Valentino's syndrome, improving diagnostic accuracy.
The authors conducted a retrospective analysis of all diagnosed cases of Valentino's syndrome from multiple facilities within the same organization for the research study. A total of 14 nonsequential cases were gathered. The term "Valentino's syndrome" was used to search in the PubMed and Google Scholar databases for the review of literature, and only 17 cases were found and reviewed.
Of the 31 patients, 83.9% were male, with a mean age of 39 years. Of all patients who presented with abdominal pain, 25.8% had it in the lower right abdomen. Vomiting (38.7%), nausea (35.4%), fever (16.1%), and constipation were all associated symptoms (12.9%). All cases were clinically diagnosed as acute appendicitis. Many patients had elevated levels of white blood cells, neutrophils, and CRP. Computed tomography (CT) scan was used in 70.9% of the cases, followed by ultrasound (58%) and x-ray (45.1%), where pneumoperitoneum and duodenal perforations were common. Graham's patch was used in 48.3% of the cases, appendectomy was used in 16.1% of the cases, and conservative care was used in 19.3% of the cases. Most patients were given proton pump inhibitors and antibiotics for Helicobacter pylori.
Timely diagnosis of Valentino's syndrome via CT imaging is critical because it leads to immediate perforation repair. Patients' mortality and morbidity may be reduced if they are aware of the condition and receive an accurate, rapid preoperative diagnosis.
在急诊室，急性腹痛是患者最常见的症状之一，其病因众多，导致鉴别诊断过程繁琐。消化性溃疡穿孔是急性右下腹或下腹部疼痛的罕见原因。它会导致该区域胃肠道内容物渗漏，引发局部炎症和疼痛，临床上与急性阑尾炎相似。这种情况被称为瓦伦蒂诺综合征。
本研究旨在突出瓦伦蒂诺综合征患者的临床和影像学特征，提高诊断准确性。
作者对同一组织内多个机构所有诊断为瓦伦蒂诺综合征的病例进行了回顾性分析，共收集了14例非连续性病例。使用“瓦伦蒂诺综合征”一词在PubMed和谷歌学术数据库中检索文献综述，仅发现并回顾了17例病例。
31例患者中，83.9%为男性，平均年龄39岁。所有出现腹痛的患者中，25.8%的疼痛位于右下腹部。呕吐（38.7%）、恶心（35.4%）、发热（16.1%）和便秘（12.9%）均为相关症状。所有病例临床均诊断为急性阑尾炎。许多患者白细胞、中性粒细胞和CRP水平升高。70.9%的病例使用了计算机断层扫描（CT），其次是超声（58%）和X线（45.1%），常见气腹和十二指肠穿孔。48.3%的病例采用了格雷厄姆补片，16.1%的病例进行了阑尾切除术，19.3%的病例采用了保守治疗。大多数患者接受了质子泵抑制剂和针对幽门螺杆菌的抗生素治疗。
通过CT成像及时诊断瓦伦蒂诺综合征至关重要，因为这能立即进行穿孔修复。如果患者了解病情并获得准确、快速的术前诊断，其死亡率和发病率可能会降低。
