A child of 5 years old with suspected appendicitis came to emergency department of city children hospital and is sent for an abdomen ultrasound scan. At ultrasound in the right iliac area visualizes the lesion of a bizarre, close to ovoid shape (almost triangular), predominantly anechogenic with some echogenic microinclusions with a mild comet tail artifact (air?), with a thick wall (intestinal wall?) and a wide base ("sessile" lesion) passing into the intestinal loop, is not compressed by a ultrasound probe (image 2 - lesion movement with compression by a probe), on the CFM, blood flow along the contour (Meckel diverticulum? enterocyst / duplication intestinal cyst? abscess? polyp? others?). The most likely diagnosis is an intraluminal enterocyst or submucosal ileal hamartoma - external link Which can be a "lead point" for intestinal intussusception and can explain the pain. external link | 
