Valantino, s Syndromevalintino's syndrome., means, perforated peptic ulcer with unusual clinical prsentation, mainly clinicaly& Radiosonograficaly dignosed acute appendicitis, when perforated peptic ulcer originated fluid from the stomach through perforated peptic ulcer that travels through the peritoneal sac into the Rt iliac fossa, causing irritation& information of the surroundings leading to appendicitis. Case study, at Mnuof emergency surgical department by Dr. Mohammed Gaber Abdalla Ragab 16 years old presented with abdominal pain of 72 hrs progression, the clinical interview, physical examination, Radiosonography findings were consistent with complicated acute appendicitis, during opertion a spill of stomach fluid was observed spilled through the gutter, by exploration, show the presence of large gastric perforation, & fluid spilled through it.