A case of ileocecal duplication cyst protruding into the intestinal lumen enucleated via an anti-mesenteric approach

Abstract Ileocecal duplication cysts are generally treated with ileocecal resection and end-to-end anastomosis. However, loss of the ileocecal valve can be a problem in childhood. Cyst enucleation is an option to preserve the ileocecal valve, but is difficult for cysts protruding into the intestinal lumen. We report a case of ileocecal duplication cyst with luminal protrusion successfully enucleated via an anti-mesenteric approach. A 4-year-old boy complaining of abdominal pain was referred to our hospital with a diagnosis of intussusception. Intussusception was reduced with a therapeutic enema, but a tumor was detected in the ascending colon. Ultrasonography showed a cystic tumor adjacent to the ileocecal valve partially sharing the muscle wall with the colon. Surgery was performed with a diagnosis of duplication cyst. The ileocecum was mobilized laparoscopically and exteriorized through the umbilicus. The cyst did not protrude outside the colon, making enucleation difficult. We incised the cecum on the anti-mesenteric side, isolated the cyst, and resected it with preservation of the ileocecal valve. The patient's postoperative course was uneventful. Nine months after surgery, he remains well, with no sign of recurrence. An anti-mesenteric approach is a good option to preserve the ileocecal valve for ileocecal duplication cysts protruding into the lumen.