Untwisting the diagnosis: antenatal detection of caecal volvulus mimicking abdominal mass

Fetal caecal volvulus is an extremely rare entity, scarcely reported in antenatal imaging literature. Early diagnosis and prompt surgical intervention are crucial to prevent bowel necrosis, fetal demise and post-natal complications. We present a rare case of fetal caecal volvulus at 34 weeks of gestational age, diagnosed on antenatal ultrasound and fetal magnetic resonance imaging mimicking a heterogenous cystic intra-abdominal mass and confirmed on post-natal surgery. To our knowledge, caecal volvulus has never been reported in existing fetal imaging literature. This case highlights the importance of antenatal imaging in differentiating abdominal masses and detecting rare gastrointestinal emergencies in utero.