We report a rare case of duplication of the transverse colon in an adult. A 26-year-old male presented to our hospital with upper left abdominal pain and fever. An abdominal computed tomography scan revealed an inflammatory mass in the gastrocolic ligament. Although conservative management with fasting and antibiotics ameliorated the abdominal pain, the mass remained approximately 5cm at its largest diameter. Further investigation with a Gastrografin(®) enema revealed a fistula in the central part of the transverse colon. A perforation of the transverse colon was intraoperatively detected; therefore, both the intra-abdominal abscess and part of the transverse colon were excised. Pathological examination revealed duplication of the transverse colon that was lined with ciliated columnar epithelium, squamous epithelium, and heterotopic glands.

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