Cecal duplication cyst mimicking intussusception in a female: A case report

Cecal duplication cysts occur only in 0.4% of all the gastrointestinal tract duplication cysts. More than 80% cases present in the first two years of life. However, asymptomatic individuals may also present in adult life.

A female patient of 42 years presented with generalized abdominal pain and multiple episodes of vomiting from one day. A vague tender mass was palpable in the left lumber region, firm in consistency with ill-defined borders and not moving with respiration. Ultrasound shows mild free fluid with internal debrinous echoic area noted in lower abdomen and pelvis along with fatty hepatomegaly. CeCT scan of the abdomen and pelvis shows twisted appearance of the gut and mesentery in right sub-hepatic region. Complete resection and Ileocolic anastomosis was done along with right hemicolectomy. Based on radiological, surgical and pathological findings, the final diagnosis was enteric duplication cyst.

Based on their location, terminal ileum and ileocecal junction are the most common sites (53 %) with colonic duplication second to it (13%). However, cecal duplication cysts remain the least common with incidence of 0.4 % only. Females are more common than males. However, their exact cause is not known. Possible causes are defective recanalization, fusion of embryonal longitudinal folds, persistant diverticulae of embryonic life and uterine vascular anomalies.

Enteric duplication cysts most commonly presenting with palpable abdominal mass, pain mimicking appendicitis & bleeding per-rectum. The treatment of choice is resection and ileocolic anastomosis with overall good prognosis. The delay in the diagnosis can lead to high mortality.