Waugh's Syndrome in an Adult Patient: A Case Report and a Review of the Literature

Waugh's syndrome is a rare disease that typically presents as acute-onset intussusception caused by gut malrotation. This disease, while generally reported during infancy or childhood, can also affect adults. This case report describes the rare case of Waugh's syndrome in an adult with cystic fibrosis. The patient, a 19-year-old male, was admitted one week after the onset of pain and distention in the abdomen, with vomiting alternating with constipation. He had visited emergency rooms in the past and was taking symptomatic treatment, but on arrival at our facility, he developed a tonic-colonic convulsion. The evaluation showed respiratory acidosis, severe hyponatremia, and abdominal distension with an empty rectum. The patient was discovered to have colo-colonic intussusception by imaging, and he was admitted into the intensive care unit before exploratory surgery. Surgical findings showed intestinal malrotation with the cecum lying in the left upper quadrant and ilio-colic intussusception extending to the mid-rectum. A distal ileal resection was required for partial reduction, leaving a residual segment needing an ileostomy. Histopathology performed after surgery found a blocked lumen, edema hemorrhage, and necrosis. Following discharge, the patient's recovery was hampered by a high-volume stoma. He had to be readmitted for electrolyte correction and hydration as well as preparation of the normal passage of foods through his system. Later follow-up showed that the output of the stoma had been brought under control, and nutritional status greatly improved. The patient planned to have a stoma reversal after three months. This case emphasizes the need for a multidisciplinary approach to treating Waugh's syndrome in adult patients.