Duplication Cyst in an 11-Year-Old Presenting as Acute Intestinal Obstruction: A Case Report

Gastrointestinal (GI) duplication cysts are uncommon congenital anomalies that may present with intestinal obstruction, GI bleeding, or malabsorption. Duplication cysts smaller than 1 cm are rarely reported and are seldom implicated in causing obstruction. We report the case of an 11-year-old boy who presented with acute intestinal obstruction, characterised by bilious vomiting, abdominal pain, and distension. Contrast-Enhanced Computed Tomography (CECT) revealed features of distal ileal obstruction, although the underlying aetiology was not visualised. Intraoperatively, a 6.5 mm cystic lesion was identified on the mesenteric border of the ileum, leading to kinking and obstruction due to surrounding adhesions. Wedge resection with end-to-end anastomosis was performed. Histopathological examination confirmed the lesion as an enteric duplication cyst. This appears to be the first documented case of such a small duplication cyst causing mechanical intestinal obstruction, in contrast to the typically larger lesions reported in the literature. The child was followed up for three months postoperatively, during which he remained asymptomatic and showed normal growth and development. This case highlights the diagnostic and therapeutic challenges posed by small, radiologically occult duplication cysts.