‘Internal mesenteric hernia’

High grade small bowel obstruction :- Marked dilatation of small bowel loops demonstrating multiple air fluid levels with collapsed, stretched distal ileal loop in lower abdomen at the level of common iliac artery with twisting of the vessels around (Whirl pool sign) , suggesting ‘internal mesenteric hernia’ versus ? mesenteric adhesions.

Trace free fluid in abdomen and pelvis. No evidence of pneumoperitoneum.