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

## TL;DR

A rare case of large bowel obstruction caused by a calcified uterine fibroid is reported, emphasizing the need to consider gynecological causes in postmenopausal patients.

## Contribution

Highlights an exceptionally rare extrinsic cause of bowel obstruction due to a calcified uterine fibroid in a postmenopausal woman.

## Key findings

- Computed tomography identified calcified masses compressing the ascending colon and causing partial caecal volvulus.
- Surgical intervention confirmed a benign calcified uterine fibroid as the cause of obstruction.
- The patient recovered uneventfully after myomectomy and was discharged on postoperative day four.

## Abstract

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.