This is a case report on a 6-month-old child with an intestinal duplication cyst (ID), initially diagnosed as intussusception. As the patient failed to improve clinically after an apparently successful enema reduction, surgery was performed and an ID was found causing compression and strangulation of the ileum. ID should be considered in small children presenting with acute abdomen. This history also emphasises the need to consider alternative diagnosis to intussusception when initial enema reduction fails to relieve symptoms.

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