Objective: To document the case of a 33-year-old man with a history of chronic cocaine use who presented with acute appendicitis and gastric perforation at Hospital General Ambato. Brief description of the case: patient with abdominal pain of 4 days of evolution who underwent emergency surgery for acute inflammatory abdomen initially considered acute appendicitis and based on Rx pneumoperitoneum was observed, exploratory laparotomy was performed, finding gastric perforation and peritonitis secondary to the presence of fluid in the right parietal colic sliding (Valentino syndrome), the lesion was affiliated, cavity washed and appendicectomy was performed. Conclusion: Among the adverse gastrointestinal effects of cocaine and its derivatives, there is perforation of the hollow viscera. It would be advisable for a thorough interrogation on the consumption of cocaine and other drugs or the request of their presence in the urine and the clinical suspicion of non-occlusive intestinal ischemia caused by cocaine in those young adults without cardiovascular risk factors who present with acute abdominal symptoms, especially to plan the correct treatment

gastric ulcer, cocaine, acute appendicitis, Valentino's syndrome