Diagnostic dilemma of cecal duplication.

INDIAN PEDIATRICS 749 VOLUME 41JULY 17, 2004 A 7-day-old full term male neonate was referred with persistent bilious vomiting and mass in the abdomen. The antenatal scans were normal. The child had passed meconeum and was feeding well. On examination, abdomen was mildly distended and nontender. There was an intra abdominal mass in the right lumbar region extending towards the right hypo-chondrium. Hemato-logical and biochemical examinations were normal. X-ray of the abdomen showed a soft tissue mass in the right lumbar region. Ultrasound scan showed a cystic mass 5.4 × 3.5 cm in size below the lower surface of the liver with posterior enhancement. The liver, gall bladder, kidneys, spleen and great vessels were normal. With the probable diagnosis of mesenteric cyst or bowel duplication, the child underwent a laparotomy. We found a cystic mass arising from the medial aspect of the cecum, which was intimately related, but not communicating with the cecum. There was a single appendix attached to the parent cecum (Fig. 1). A local ileo-cecal resection with end-to-end anastomosis was performed. Postoperative recovery was uneventful. Histopathological examination confirmed the diagnosis of cecal duplication. There was no ectopic mucosa seen. Six-month follow up has been uneventful.