Large Bowel Obstruction From a Calcified Uterine Fibroid: A Rare Cause of Extrinsic Compression

Large bowel obstruction is a surgical emergency most commonly caused by colorectal malignancy, volvulus, or diverticular disease. Extrinsic compression of the colon from gynaecological pathology is rare, and bowel obstruction secondary to uterine fibroids is exceptionally uncommon. We present the rare case of a 72-year-old postmenopausal woman who presented with acute intermittent abdominal pain, vomiting, and obstipation. Computed tomography demonstrated calcified masses adjacent to the ascending colon with proximal bowel dilatation, consistent with large bowel obstruction. A laparotomy was performed by the general surgery team, and a large calcified exophytic uterine fibroid was found to be compressing the caecum and causing secondary partial caecal volvulus. The obstruction was relieved, and myomectomy was performed after consultation with the gynaecology team. Histopathological examination confirmed a benign leiomyoma with extensive calcification. The patient made an uncomplicated recovery and was discharged on postoperative day four. This case highlights an unusual cause of large bowel obstruction and underscores the importance of considering gynaecological pathology in the differential diagnosis of atypical obstructive presentations, particularly in postmenopausal patients.