Patients with perforated Valentino's syndrome usually present with a sudden onset of severe, sharp abdominal pain in the right lower quadrant (RLQ), that is similar to acute appendicitis. Most patients describe generalized pain; a few present with severe epigastric pain, located in the upper abdominal area.
The description of perforated Valentino's syndrome emphasizes the sudden onset of severe pain in the right lower quadrant (RLQ), often mimicking acute appendicitis.  Some patients may have more widespread pain, while others experience localized epigastric pain.