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Context: Abdominal pain is a common symptom in gastrointestinal diseases. It occurs through different mechanisms and its location usually guides us in making differential diagnoses. Valentino syndrome is a pathology that presents with atypical symptoms that simulate acute appendicitis. We present the case of a 30-year-old male patient presented with pain in the right iliac fossa. Given the clinical suspicion of acute appendicitis and the laboratory and imaging findings, exploratory laparotomy was performed. Since no inflammatory changes were evident in the appendix, it was decided to perform a thorough abdominal examination, and an important finding was a gastric perforation, where the gastric and duodenal fluids traveled through the paracolic gutter, being located in the right lower quadrant and causing focal peritonitis.This syndrome, given its genesis and inadequate management, should be given special importance and maintained as a differential diagnosis due to the considerable mortality it entails.
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