What is a serious diagnosis one can miss when a patient presents with features of appendictis in the ER which is associated with pain epigastrium?

any lap surgeons miss this important diagnosis,leading to increased re operation rates , morbidity and mortality

this is a trick diagnosis and missed by many general surgeons and ER doctors

DU perforation can mimic acute appendicitis cos the leaking HCl causes  chemical appendicitis which resolves after some hours ,but the DU symptoms increase

This syndrome is called Valentino syndrome ,named after the famous New York City actor in the 1920s Rudolf Valentino who was misdiagnosed and died of multi organ failure a few days later

Many lap surgeons miss this important diagnosis,leading to increased re operation rates , morbidity and mortality