Enteric duplication cysts are rare and uncommon congenital malformations affecting 1 in 4500 births formed during the embryonic period of development of the human digestive system. They are mainly encountered during infancy or early childhood, but seldom in adults. The clinical presentation is extremely variable depending upon its size, location and type in which majority of affected patients present in first 2 years of life with per rectal bleeding, palpable lump or intestinal obstruction. The commonest location of these cysts is in small bowel but ileo-cecal cysts are exceedingly rare. Some of them may remain asymptomatic and present in the adulthood. The lesion may be tubular or cystic. Several theories have been postulated, but true etiology is not known. We report a case of cecal duplication cyst in a 2-year-old male child who presented in the Outpatient Department of General Surgery at Surat Municipal Institute of Medical Education & Research (SMIMER), Surat, Gujarat, India with complaints of abdominal pain and signs suggestive of intestinal obstruction, resulting into a diagnostic dilemma. This report implies that although alimentary tract duplications are rare, they should be considered in the differential diagnosis of children who presents with acute abdominal pain. Excision of the cyst along with right hemicolectomy followed by ileo ascending anastomosis was done. The child had an uneventful postoperative recovery.

Keywords: Caecal duplication cyst, Intestinal obstruction due to caecal duplication cyst, Alimentary tract