Retroperitoneal duodenal ulcer mimicking appendicitis associated with Valentino’s syndrome – A rare case report

Valentino’s syndrome is a rare presentation of retroperitoneal perforated peptic ulcer disease Ulcer, which can present as a right illac fossa tenderness mimicing acute appendicitis (AA). The purpose of the report is to highlight on rare presentation of right iliac fossa (RIF) tenderness in a suspected case of AA, later diagnosed to be Valentino’s syndrome. We report a case 60 years old patient who presented with pain in the right groin associated with fever. The diagnosis was inconclusive after routine examination and investigations; therefore, an exploratory laparotomy was performed. An exploratory laparotomy revealed a retroperitoneal perforation of posterior wall of duodenum which was followed by the graham’s patch repair. Postoperatively, antibiotics were prescribed and the patient was discharged without any complication. A differential diagnosis of Valentios syndrome for perforated duodenal ulcer must be considered, while examining a case of pain in the RIF. The final diagnosis may be intraoperative; however, contrastenhanced computed tomography scans remain gold standard.