Twisted ovarian dermoid cyst with sigmoid colon volvulus: a rare cause of closed-loop obstruction

Ovarian dermoid cysts (mature cystic teratomas) are common benign ovarian tumors, but they rarely cause intestinal obstruction. We present an extremely rare case of a large twisted left ovarian dermoid cyst with an edematous pedicle, around which the sigmoid colon had looped, leading to a closed-loop obstruction, rarely seen in young adults, which can be a life-threatening condition, if remains untreated. A 34-year-old female presented with left lower abdominal pain since three days, associated with obstipation and multiple episodes of non-bilious vomiting. Contrast-enhanced computed tomography (CECT) of the abdomen revealed a large left ovarian dermoid cyst with a twisted pedicle, causing sigmoid colon entrapment and luminal narrowing. She underwent an emergency exploratory laparotomy with resection of the redundant sigmoid colon and side-to-side colocolic anastomosis alongwith left oophorectomy. The patient had an uneventful recovery and was discharged on post-operative day 6 with soft diet and a healthy wound. This case highlights a rare but significant complication of ovarian dermoid cysts leading to intestinal obstruction.