{
  "abstract": "Valentino's syndrome (VS) is a rare presentation of perforated peptic ulcer disease causing right lower quadrant (RLQ) pain mimicking acute appendicitis. Secondary appendiceal perforation with fungal colonization is exceptionally uncommon. A 65-year-old woman presented with worsening RLQ pain, nausea, vomiting, diffuse peritoneal irritation, McBurney tenderness, and hemodynamic instability. Contrast-enhanced computed tomography demonstrated pneumoperitoneum, a pre-pyloric gastric wall defect, and periappendiceal inflammation suggestive of VS. Exploratory laparotomy confirmed generalized peritonitis from pre-pyloric gastric perforation with contamination tracking along the right paracolic gutter. A retrocecal appendix with secondary tip perforation further obscured the diagnosis. Appendectomy and primary gastric repair were performed. Histopathology showed extensive necrosis and fungal hyphae morphologically consistent with Aspergillus spp. on Grocott-Gomori methenamine silver staining, interpreted as secondary fungal involvement. This case broadens the clinical spectrum of VS and highlights careful histopathological interpretation in severely necrotic tissue.",
  "abstract_shown": true,
  "affiliations": [
    "Emergency Department, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Surgery, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Academic Hospital, Jl. Jaksa Agung Suprapto No. 2, Klojen, Malang 65111, Indonesia.",
    "Department of General Surgery, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Internal Medicine, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Radiology, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Anesthesiology and Intensive Therapy, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Anatomical Pathology, Dr. Soepraoen Army Hospital, Jl. S. Supriadi No. 22, Sukun, Malang 65147, Indonesia.",
    "Department of Anatomical Pathology, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Jl. Jaksa Agung Suprapto No. 2, Klojen, Malang 65111, Indonesia.",
    "Department of Clinical Microbiology, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Jl. Jaksa Agung Suprapto No. 2, Klojen, Malang 65111, Indonesia."
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nicholas Wijaya",
      "orcid": "0000-0002-6597-5955"
    },
    {
      "affs": [
        0
      ],
      "name": "Hanif Ardiansyah Sulistya",
      "orcid": "0000-0002-5032-2775"
    },
    {
      "affs": [
        1
      ],
      "name": "Wahju Sigit Tjahjono Putro",
      "orcid": "0009-0003-7201-513X"
    },
    {
      "affs": [
        0
      ],
      "name": "Jauhar Tajudin",
      "orcid": "0009-0000-6961-3145"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Aditya Rachmat Febrianto",
      "orcid": "0009-0006-6721-3395"
    },
    {
      "affs": [
        0
      ],
      "name": "Clarishella Melvina Deinera",
      "orcid": "0009-0003-5492-2166"
    },
    {
      "affs": [
        3
      ],
      "name": "Budi Prakoso"
    },
    {
      "affs": [
        4
      ],
      "name": "Wisniardhy Suarnata Pradana",
      "orcid": "0000-0001-8637-0077"
    },
    {
      "affs": [
        5
      ],
      "name": "Muhammad Rodli",
      "orcid": "0009-0007-1143-3425"
    },
    {
      "affs": [
        6
      ],
      "name": "Neviana Fitri Lestari"
    },
    {
      "affs": [
        7
      ],
      "name": "Nayla Rahmadiani",
      "orcid": "0000-0003-1514-777X"
    },
    {
      "affs": [
        8
      ],
      "name": "Mohammad Agung Marzah",
      "orcid": "0000-0001-8709-3665"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1xsfark4c5pty.bib",
  "cited_by": 0,
  "doi": "10.1093/jscr/rjag945",
  "fulltext_url": "https://europepmc.org/articles/PMC13711082",
  "id": "1xsfark4c5pty",
  "issns": [
    "2042-8812"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948013",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00910"
    ],
    [
      "heading",
      "Case Report"
    ],
    [
      "heading",
      "jscrep/0160"
    ],
    [
      "openalex",
      "2711|Appendicitis Diagnosis and Management"
    ]
  ],
  "openalex": "W7223821381",
  "pdf_url": "https://europepmc.org/articles/PMC13711082?pdf=render",
  "pmcid": "PMC13711082",
  "pmid": "42948013",
  "published": "2026-10-27",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/1xsfark4c5pty.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:33Z",
      "native_id": "MED:42948013",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948013"
    },
    {
      "first_seen": "2026-10-31T12:21:55Z",
      "native_id": "PMC13711082",
      "source": "pmc",
      "url": "https://doi.org/10.1093/jscr/rjag945"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Gastrointestinal disorders and treatments",
      "subfield": "surgery"
    }
  ],
  "title": "Valentino's syndrome with secondary appendiceal perforation and fungal involvement.",
  "title_text": "Valentino's syndrome with secondary appendiceal perforation and fungal involvement.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:55Z",
  "url": "https://research.draconitic.com/paper/1xsfark4c5pty",
  "venue": "Journal of surgical case reports",
  "versions": []
}