A Complicated Ileal Duplication Cyst in a Young Adult: The Value of the “Gut Signature”

Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.