Valentino's Syndrome With Two Different Clinical Phenotypes in Adolescents and Adults; A Case Series

Abstract

Aim: Valentino's Syndrome is a very rare condition and basically can be described as duodenal ulcer perforation mimicking the clinical findings of acute appendicitis. It is named after the actor Rudolph Valentino, who had undergone surgery for assumed acute appendicitis and turned out to have a perforated ulcer. The actor died in 1926 days after the surgery. We present a case series of adult and adolescent patients with Valentino's Syndrome with two different clinical presentations. Materials and Methods: Medical records of 6 patients who had Valentino's Syndrome were retrospectively evaluated. Results: All of the patients were males with a median age of 16,65 years (range: 13-27 years). Clinical and radiological findings suggested acute appendicitis in all of them. On surgical exploration, all had duodenal perforation with a grossly normal appearing appendix. Duodenal wall was intact in 3 (50%), suggesting recovered perforation, and all underwent appendectomy without an attempt for duodenal repair. The other 3 received duodenal repair for obvious perforation. Discussion: Although Valentino's is regarded as a myth by many, we present the most satisfactory and well-documented series. Differential diagnosis of patients with acute abdomen has become more prominent recently as the popularity of nonoperative management of acute appendicitis is increasing. Although rare, Valentino's should be kept in mind in patients with unexpected operative findings or in patients with inconsistent clinical findings.