Coexistence of cecal duplication cyst and Meckel's diverticulum presenting as intussusception in a malnourished child a case report with literature review.
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Alimentary tract duplications, or enterocystomas, are relatively uncommon developmental anomalies that can occur anywhere from the mouth to the anus. One-third of these enteric duplications present within the neonatal period, while the remaining two-thirds appear within the first two years of life. However, some cases may manifest in later childhood or even adulthood. The diagnosis is often incidental, though patients may present with abdominal pain or obstructive symptoms. In certain cases, these lesions can serve as leading points for intussusception in children, which is a common cause of emergency surgical admission in pediatric surgical units. We present the case of a 15-month-old male child who was admitted to our pediatric surgery unit with acute intestinal obstruction due to intussusception. Clinical evaluation and ultrasonography confirmed the diagnosis of bowel obstruction secondary to intussusception. During surgery, the intussusception was found to involve the distal ileum, cecum, ascending colon, and extended through the transverse colon down to the rectum. A cystic mass in the cecum, identified as the lead point, was observed causing the bowel segments to telescope into one another, with the intussuscepted segment protruding through the anal canal. All affected bowel segments were carefully reduced, revealing a cystic mass in the proximal cecum serving as the lead point for intussusception. A Meckel's diverticulum was also identified at a distinct site in the ileum, proximal to the location of the intussusception. A right hemicolectomy and Meckel's diverticulectomy were performed, followed by the creation of a diverting loop ileostomy. Histopathological examination confirmed the lesion to be a duplicated cyst. The postoperative course was uneventful. This report highlights a rare coexistence of cecal duplication cyst and Meckel's diverticulum causing intussusception, a combination scarcely reported in pediatric surgical emergencies.