Extremely rare cause of acute abdomen in a child

A 5-year-old boy presented to our emergency department because of sudden onset of abdominal pain and nausea that begun two days before admission. The pain was located at whole right hemiabdomen, especially periumbilically and in the upper right quadrant. The patient had no past medical history. The patient was conscious, his blood pressure of 115/75 mmHg, pulse 84 beats/min, and body temperature 36.6°C. On physical examination palpable mass in the epigastrium and right upper quadrant was found. The patient had direct and rebound tenderness on the right side, especially in right upper quadrant accompanied with abdominal distension. The white blood cell count was 12.40x109/l and C reactive protein level was 26.6 mg/l. All other laboratory examinations showed normal values. Abdominal ultrasonography revealed the presence of a giant cyst in whole right hemiabdomen and measuring 12.6 x 10.0 cm. Findings prompted a subsequent CT scan of abdomen (Fig. 1).