The condition is usually asymptomatic.
Occasionally, the diverticulum becomes inflamed and presents with features similar to acute appendicitis, except that the abdominal tenderness may be more medially sited, and accompanied by umbilical cellulitis. Perforation results in local or generalised peritonitis.
More commonly, the diverticulum presents as an intussusception or a volvulus. The clinical features may be those of an intermittent right-sided abdominal mass with associated pain.
A Meckel's diverticulum may also contain ectopic gastric mucosa in which peptic ulceration can produce haemorrhage or perforation. Ulceration may cause pain around the umbilical area that is related to meals.
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