Abstract
A two-year-old boy was brought to our hospital with intermittent abdominal pain and vomiting. Ultrasonography showed a 58 mm cystic tumor with the echogenic inner rim sign at the right lateral region of the abdomen, and we suspected a duplication cyst. The following day, he was discharged because the cyst size decreased by 30 mm and his pain had improved. However, one week later, he came back because his pain worsened and the cyst size increased by 63 mm, and thus an emergency operation was performed on him the next day. Laparoscopic observation revealed a twisted cyst that connected with the umbilicus by a narrow band on the distal side and connected with Meckel’s diverticulum at 50 cm from the ileocecal region on the proximal side. Thus, we diagnosed him as having a torsion of the omphalomesenteric cyst coexisting with Meckel’s diverticulum, and we then performed partial ileal resection, including the lesion. A histological analysis revealed that the twisted cyst had necrotized tissue with the gut component. Reports of an omphalomesenteric cyst connecting with the diverticulum are rare, and we can explain that the change in the cystic size in the present case was caused by the communication between the cyst and Meckel’s diverticulum. If we find an abdominal enteric cyst that changes its size, we should perform surgery as early as possible because there is the risk of ischemic changes, perforation, and bowel obstruction due to the torsion of this cyst, besides the enteric duplication cyst.
