Transverse colon volvulus in the 3rd trimester of pregnancy

Colonic volvulus, although the cause of less than 2% of large bowel obstructions, is the overall third leading cause of large bowel obstruction in the USA. Of these cases, less than 1% are described to be volvulus of the transverse colon, as volvulus most commonly affects the sigmoid colon or caecum. In the context of pregnancy, there is an even greater paucity of information regarding the management of volvulus. We report a case of a female in her 20s who presented at 33 weeks and 6 days during her first pregnancy with concern for large bowel volvulus. Initially managed endoscopically, after extensive discussion with family, obstetrics team and maternal foetal medicine team, the decision was made to pursue delivery and surgical intervention concurrently.