An 8-year-old male patient presenting to the emergency department (ED) with right lower quadrant pain. Axial view US image shows a cystic mass with thick wall suggested for “double-wall” sign: The mucosa appears hyperechoic (arrow) whereas the muscular layer hypoechoic (dashed-line arrow). Laparoscopic surgery and histopathologic examination confirmed the ileal duplication cyst causing intestinal obstruction