Waugh’s Syndrome in Adulthood: A Case Report of a Rare Combination of Intestinal Malrotation and Ileocolic Intussusception
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Intestinal malrotation is an uncommon congenital anomaly resulting from abnormal rotation and fixation of the midgut during embryologic development. Although typically diagnosed during infancy, presentation in adulthood is rare and frequently associated with nonspecific symptoms. Adult intussusception is also an unusual condition and is commonly related to an underlying pathological lead point. The coexistence of intestinal malrotation and intussusception, known as Waugh’s syndrome, is exceptionally rare in adults. We report the case of a 76-year-old male presenting with intermittent abdominal pain, increased bowel frequency, and weight loss over two weeks. Physical examination revealed a palpable abdominal mass. Abdominal ultrasonography and contrast-enhanced computed tomography demonstrated ileocolic intussusception associated with intestinal malrotation. Exploratory laparotomy confirmed the diagnosis, revealing abnormal positioning of the bowel and an unreducible ileocolic intussusception. The patient underwent right colectomy with en bloc mesocolic resection and ileocolic anastomosis. Histopathological examination identified an inflammatory fibroid polyp as the lead point. Postoperative recovery was uneventful. Although rare, the association of intestinal malrotation and adult intussusception should be considered in patients presenting with bowel obstruction and atypical abdominal symptoms. Early recognition and surgical treatment are essential to achieve favorable outcom
Abstract
Intestinal malrotation is an uncommon congenital anomaly resulting from abnormal rotation and fixation of the midgut during embryologic development. Although typically diagnosed during infancy, presentation in adulthood is rare and frequently associated with nonspecific symptoms. Adult intussusception is also an unusual condition and is commonly related to an underlying pathological lead point. The coexistence of intestinal malrotation and intussusception, known as Waugh’s syndrome, is exceptionally rare in adults. We report the case of a 76-year-old male presenting with intermittent abdominal pain, increased bowel frequency, and weight loss over two weeks. Physical examination revealed a palpable abdominal mass. Abdominal ultrasonography and contrast-enhanced computed tomography demonstrated ileocolic intussusception associated with intestinal malrotation. Exploratory laparotomy confirmed the diagnosis, revealing abnormal positioning of the bowel and an unreducible ileocolic intussusception. The patient underwent right colectomy with en bloc mesocolic resection and ileocolic anastomosis. Histopathological examination identified an inflammatory fibroid polyp as the lead point. Postoperative recovery was uneventful. Although rare, the association of intestinal malrotation and adult intussusception should be considered in patients presenting with bowel obstruction and atypical abdominal symptoms. Early recognition and surgical treatment are essential to achieve favorable outcomes.