There a few segments of dilated small bowel loops seen in the pelvis, prompting a search for transition point(s) to imply small bowel obstruction. Here there are two: one is proximal (@Key Finding 1) and the other distal (@Key Finding 2) in very close proximity to the proximal transition point. The case is therefore suspicious for a closed loop obstruction. Notice also how the small bowel more upstream of the proximal transition point is not dilated. This is why closed loop physiology is dangerous as all the pressure is built up inside the short segment of obstructed small bowel and cannot decompress to the remainder of the upstream bowel.

In this case, there is also mural thickening with hypoenhancement and substantial stranding (@Key Finding 3) very suspicious for bowel wall ischemia as a result of the obstruction. Urgent surgical consultation is needed here and closed loop obstruction was surgically confirmed.