Abstract
Alimentary tract duplications are a rare congenital anomaly. Their clinical manifestation may vary depending on the location, size and communication with the adjacent bowel. We present a rare case of a 2-year-old girl who was admitted with intermittent ab-dominal pain, low-grade fever, and signs suggestive of complicated appendicitis. Laboratory investigations revealed elevated inflammatory markers. Abdominal ultrasound and CT scan demonstrated a right-sided mass compressing the cecum, with radiological features suggestive of a fecaloma, possible intussusception, or retroperitoneal abscess. Surgical exploration revealed a large retroperitoneal mass adherent to the cecum and surrounding structures. An ileocecal resection with end-to-side ileocolic anastomosis was performed. Histopathological analysis confirmed a complicated cecal duplication cyst with fecal impaction and chronic inflammation. Cecal duplication cysts, though rare, should be considered in the differential diagnosis of right lower quadrant masses in children. Surgical resection remains the definitive treatment, particularly in complicated cases. Timely detection and appropriate surgical management can lead to excellent outcomes.