Colonic intestinal duplication as a guide point associated with Waugh syndrome in an infant. First national case
Jesús R Aguirre-López1, Isaías Gómez-Barrera1, Othón Romero-Terán1
1Servicio de Cirugía Pediátrica, Hospital Regional Licenciado Adolfo López Mateos, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México.
Insights
Waugh syndrome, a rare cause of intestinal obstruction, can involve intestinal malrotation and invagination. This case highlights a unique instance of colonic intestinal duplication acting as a lead point in a pediatric patient.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Case Reports
Background:
- Waugh syndrome is a rare condition characterized by intestinal obstruction due to invagination and malrotation.
- It is infrequently reported in medical literature.
- This case focuses on a rare presentation of Waugh syndrome in an infant.
Purpose of the Study:
- To present a clinical case of a male infant with multiple intestinal obstructions.
- To highlight Waugh syndrome as the underlying cause.
- To emphasize the role of colonic intestinal duplication as a lead point.
Main Methods:
- An emergency exploratory laparotomy was performed on a 4-month-old male infant presenting with mechanical intestinal obstruction.
- The surgery revealed colonic-colonic intestinal invagination with a cystic intestinal duplication of the ascending colon serving as the lead point, along with intestinal malrotation.
- Surgical intervention included ileocecocolic resection with the duplication, ileotransversoanastomosis, and Ladd's procedure.
Main Results:
- The patient underwent successful surgical correction for Waugh syndrome.
- Postoperative recovery was satisfactory.
- The infant showed good clinical evolution during a 6-month follow-up period.
Conclusions:
- Waugh syndrome remains a rare diagnosis despite its description over a century ago.
- Colo-colonic invagination is uncommon, occurring in 2.5% of cases, typically with a lead point.
- The association of colo-colonic invagination with a cystic duplication of the colon as a lead point is exceptionally rare, with no prior reports in the literature.
Background:
Waugh syndrome is named to intestinal obstruction caused by intestinal invagination and malrotation, being a pathology rarely reported. The objective is to present the clinical case of a male infant with multiple intestinal obstruction secondary to Waugh Syndrome, having as a guide point a colonic intestinal duplication.
Case Report:
A 4-month-old male patient, with no previous history of importance, previously healthy, with clinical picture of mechanical intestinal obstruction, who underwent emergency exploratory laparotomy, finding colonic-colonic intestinal invagination at the level of the ascending colon, as head of invagination or guide point a cystic intestinal duplication of ascending colon and intestinal malrotation, exvagination by cabs, ileocecocolic resection was performed, which included cystic intestinal duplication, ileotransversoanastomosis and finally Ladd's procedure. His postoperative evolution was satisfactory. Currently with good evolution at 6 months of follow up.
Conclusions:
Waugh's syndrome is a rare entity; despite having been described more than a century ago, its incidence continues to be rare. Colo-colonic invagination is infrequent, occurring in 2.5% of cases, generally associated with a guide point, as in our case, being extremely rare to cystic duplication of the colon, since there is no case reported in the literature.
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