Caecal Volvulus in Pregnancy: A Rare Cause of Intestinal Obstruction and a Diagnostic Dilemma

Caecal volvulus is an uncommon cause of intestinal obstruction during pregnancy. Despite advances in diagnostic imaging, the diagnosis of caecal volvulus remains challenging, as its presentation often resembles that of common pregnancy-related symptoms. Laboratory findings are often nonspecific and largely unremarkable due to physiological alterations associated with pregnancy. They tend to become abnormal when complications such as perforations or peritonitis occur, conditions that substantially increase maternal and fetal morbidity, and in severe cases, may result in fetal loss as reported in the literature. Hence, clinicians must maintain a high index of suspicion and promptly pursue appropriate imaging and management. We report a case of a 40-year-old woman at 27 weeks of gestation who presented with acute abdominal pain and constipation, diagnosed with caecal volvulus on magnetic resonance imaging (MRI) of the abdomen, and subsequently underwent a right hemicolectomy. Her pregnancy continued uneventfully, culminating in a healthy term delivery. This case emphasises the critical importance of maintaining high clinical suspicion and implementing timely multidisciplinary surgical management to achieve favourable maternal and fetal outcomes in this rare life-threatening condition.