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Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis

Due to the rarity of the condition, Valentino’s syndrome is an underrated differential diagnosis for acute appendicitis. We describe a patient with Valentino’s syndrome in whom preoperative and intraoperative diagnoses were challenging due to misleading clinical, investigative, and morphological fin...

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Autores principales: Rodrigo, VEU, de Silva, GPUP, Jayasinghe, DSH, Thalagaspitiya, SPB, Srishankar, S, Wickramarathne, Dickson, Karunadasa, MSE
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618742/
https://www.ncbi.nlm.nih.gov/pubmed/36324598
http://dx.doi.org/10.1177/2050313X221132069
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author Rodrigo, VEU
de Silva, GPUP
Jayasinghe, DSH
Thalagaspitiya, SPB
Srishankar, S
Wickramarathne, Dickson
Karunadasa, MSE
author_facet Rodrigo, VEU
de Silva, GPUP
Jayasinghe, DSH
Thalagaspitiya, SPB
Srishankar, S
Wickramarathne, Dickson
Karunadasa, MSE
author_sort Rodrigo, VEU
collection PubMed
description Due to the rarity of the condition, Valentino’s syndrome is an underrated differential diagnosis for acute appendicitis. We describe a patient with Valentino’s syndrome in whom preoperative and intraoperative diagnoses were challenging due to misleading clinical, investigative, and morphological findings. A 31-year-old woman who was on methylprednisolone for sensory radiculopathy presented to the emergency department with acute right lower quadrant pain. The clinical diagnosis of acute appendicitis was supported by the elevated inflammatory markers and ultrasonographic findings. An appendicectomy and an ovarian cystectomy were performed due to the findings of mild appendicitis and right ovarian endometrioma, respectively. Postoperatively, she developed peritonitis with a purulent bile-stained discharge from the surgical site and per vagina. Contrast-enhanced computed tomography of the abdomen showed a retroperitoneal collection at the second lumbar vertebral level extending along the right paracolic gutter to the pelvis and intraperitoneal fluid collections in right lower quadrant and pelvis. An emergency exploratory laparotomy confirmed a perforation at the posterior aspect of the duodenum which was repaired with an omental patch. Unfortunately, relaparotomy and end ileostomy were required due to colonic perforation with the eroded drain tube. She made an uneventful recovery with intensive care and underwent ileostomy reversal after 12 weeks. We emphasize the clues to have a high degree of suspicion during preoperative and intraoperative evaluation to recognize this lethal mimicker of acute appendicitis.
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spelling pubmed-96187422022-11-01 Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis Rodrigo, VEU de Silva, GPUP Jayasinghe, DSH Thalagaspitiya, SPB Srishankar, S Wickramarathne, Dickson Karunadasa, MSE SAGE Open Med Case Rep Case Report Due to the rarity of the condition, Valentino’s syndrome is an underrated differential diagnosis for acute appendicitis. We describe a patient with Valentino’s syndrome in whom preoperative and intraoperative diagnoses were challenging due to misleading clinical, investigative, and morphological findings. A 31-year-old woman who was on methylprednisolone for sensory radiculopathy presented to the emergency department with acute right lower quadrant pain. The clinical diagnosis of acute appendicitis was supported by the elevated inflammatory markers and ultrasonographic findings. An appendicectomy and an ovarian cystectomy were performed due to the findings of mild appendicitis and right ovarian endometrioma, respectively. Postoperatively, she developed peritonitis with a purulent bile-stained discharge from the surgical site and per vagina. Contrast-enhanced computed tomography of the abdomen showed a retroperitoneal collection at the second lumbar vertebral level extending along the right paracolic gutter to the pelvis and intraperitoneal fluid collections in right lower quadrant and pelvis. An emergency exploratory laparotomy confirmed a perforation at the posterior aspect of the duodenum which was repaired with an omental patch. Unfortunately, relaparotomy and end ileostomy were required due to colonic perforation with the eroded drain tube. She made an uneventful recovery with intensive care and underwent ileostomy reversal after 12 weeks. We emphasize the clues to have a high degree of suspicion during preoperative and intraoperative evaluation to recognize this lethal mimicker of acute appendicitis. SAGE Publications 2022-10-24 /pmc/articles/PMC9618742/ /pubmed/36324598 http://dx.doi.org/10.1177/2050313X221132069 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Rodrigo, VEU
de Silva, GPUP
Jayasinghe, DSH
Thalagaspitiya, SPB
Srishankar, S
Wickramarathne, Dickson
Karunadasa, MSE
Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title_full Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title_fullStr Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title_full_unstemmed Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title_short Valentino’s syndrome: A rare and lethal differential diagnosis for acute appendicitis
title_sort valentino’s syndrome: a rare and lethal differential diagnosis for acute appendicitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618742/
https://www.ncbi.nlm.nih.gov/pubmed/36324598
http://dx.doi.org/10.1177/2050313X221132069
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