International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A three-year-old boy with fever, under nutrition and abdominal distension previously diagnosed as ascites was submitted to laparotomy. We founded a large multi lobed cyst from the large omentum filling almost the entire abdominal cavity and containing sero-hemorrhagic to very dark liquid. The histopathologic examination showed a cystic formation lined by cubic mesothelium cells, with abundant inflammatory infiltrate rich in lymphocytes and histiocytes, mixed with a few giant cells of foreign body of melanotic origin. IJCRI publishes Review Conclusion:The diagnostic role of sonography in abdominal distension of unknown etiology is emphasized.