Duodenal Ulcer Perforation and Pneumothorax: a Case Report

Background: Valentino’s syndrome refers to acute abdomen with clinical presentation mimicking acute appendicitis in a Perforated gastric or duodenal ulcer. This occurs when suppurative fluid from duodenal perforation trickles down the paracolic gutter to the right iliac fossa causing peritonitis locally and causes periappendicitis. Less than 50 cases have been reported in literature of the same. Case report and discussion: A 42-year-old male was admitted to the general surgery department with pain in the right iliac fossa and epigastric region. A diagnostic laparoscopy was performed under the suspicion of Acute appendicitis, which was later converted to open laparotomy on finding a perforated duodenal ulcer. Review of Literature: Valentino syndrome is a rare condition in which a duodenal ulcer mimics acute appendicitis which is a diagnosed intraoperatively and managed surgically. Although the exact incidence is unknown, less than 50 cases have been reported worldwide. The first incidence reports back to 1926 when an Italian actor, Rodolfo Valentino who succumbed to this rare disease and it was named after him. Conclusion: Differential diagnosis of duodenal ulcer perforation should be considered for adult patient with diagnosis of acute appendicitis. X ray erect abdomen and diagnostic laparoscopy can help to overcome foot in mouth situation due to missed duodenal ulcer perforation. Keywords: Valentino syndrome.

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A Operative Case Report of Duodenal Ulcer Perforation with Polycythemia Vera Complicated Postoperative Acute Respiratory Distress Syndrome

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.41.2029 ◽

2008 ◽

Vol 41 (12) ◽

pp. 2029-2034 ◽

Cited By ~ 1

Author(s):

Hidetaka Yamanaka ◽

Takahiko Ishizaka ◽

Satoru Kawai ◽

Hiroyuki Matsunaga ◽

Yasushi Kitoh ◽

...

Keyword(s):

Duodenal Ulcer ◽

Acute Respiratory Distress Syndrome ◽

Case Report ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Polycythemia Vera ◽

Distress Syndrome ◽

Ulcer Perforation ◽

Operative Case ◽

Duodenal Ulcer Perforation

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Study of factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation

Medpusle International Journal of Surgery ◽

10.26611/1061921 ◽

2021 ◽

Vol 19 (2) ◽

pp. 35-39

Author(s):

Pradeep Chandra Sharma ◽

Keyword(s):

Duodenal Ulcer ◽

Previous History ◽

Common Factors ◽

Duodenal Perforation ◽

High Morbidity ◽

Delayed Presentation ◽

Mortality And Morbidity ◽

Factors Affecting ◽

Ulcer Perforation ◽

Duodenal Ulcer Perforation

Background: Peptic ulcer disease in the general population had lifetime prevalence of 5-10% with incidence of 0.1–0.3% per year. Despite the tremendous improvement in preventive therapies, the rate of complication of this disease is still high and is burdened by high morbidity and mortality. In present study, we aimed to study factors affecting mortality and morbidity in patients presenting with peritonitis due to duodenal ulcer perforation at our tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study conducted in patients admitted, diagnosed with duodenal ulcer perforation and surgically treated at our hospital. Results: In present study period total 56 patients were studied. All were male, most common age group was 51-60 years (37.5%) followed by 41-50 years (23.21%). Duration from onset of symptoms to admission was >24 hours (30.36%) in most of patients followed by 12-24 hours (28.57%). Most commons symptoms were pain in abdomen (100%), vomiting (100%). Anaemia (37.5%), LRTI and Pulmonary complications (19.64%), Diabetes mellitus (12.5%) and Hypertension (10.71%) were common comorbidities noted. Associated risk factors were previous history of PUD (41.07%), Alcohol use (64.29%), Cigarette smoking (51.79%) and Use of NSAIDs (12.5%). Presence of free gas under diaphragm was noted in 83.93% patients. Intraoperatively duodenal perforation diameter was 1–5 mm (60.71%) in most of patients followed by 6–10 mm (23.21%). Only 1 patient had duodenal perforation diameter was > 20mm. Common postoperative complications were wound infection (37.5%) and pulmonary infection (21.43%). In present study mortality within 1 month was noted in 13 patients (23.21%). Most common factors related to mortality were delayed presentation > 24 hours (61.54%), age > 60 years (46.15%), diabetes mellites (38.46%), Size of perforation > 1 cm (38.46%) and septicaemic shock (23.08%). Conclusion: Delayed presentation > 24 hours, age > 60 years size of perforation > 1 cm were common factors related to mortality in duodenal ulcer perforation patients.

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