Internal mesenteric hernia causing closed loop sbo

Bean shaped dilated, edematous/thickened distal ileal loops in lower abdomen, pelvis demonstrating hypoattenuating mucosal margins on post-contrast study with marked surrounding mesenteric fat stranding, small bowel feces associated with twisted mesenteric vessels in midline infraumbilical region with whirlpool of mesenteric vessels around – suggestive of internal mesenteric hernia causing closed loop small bowel obstruction.

Hypoattenuating mucosal margins of the dilated ileal loops – suggestive of early acute bowel ischemia.

Small free fluid in abdomen and pelvis.

No evidence of pneumoperitoneum.