Double Trouble in the Abdomen: Waugh Syndrome Presenting as Left-Sided Ileocolic Intussusception in an Infant

Waugh syndrome is a rare condition characterized by the coexistence of intestinal malrotation and intussusception. We report the case of a six-month-old infant presenting with rectal bleeding, non-projectile bilious vomiting, and fever. Clinical examination revealed a palpable abdominal mass on the left side of the abdomen. Imaging demonstrated ileocolic intussusception with features suggestive of underlying malrotation. During surgery, intestinal malrotation with the cecum located in the left upper quadrant and a long-segment ileocolic intussusception with gangrene were identified. The patient underwent manual reduction of intussusception, bowel resection with anastomosis, and Ladd’s procedure. Histopathology confirmed gangrenous changes in the resected bowel. The patient recovered well postoperatively and was tolerating feeds at discharge. This case highlights the importance of recognizing atypical presentations of intussusception and considering underlying malrotation, as management differs from isolated intussusception.