This 47 y/o female had a 1 week history of abdominal pain. She had been in good health prior to the onset of symptoms. Her only child had been delivered by c-section. On physical exam she was afebrile, had mild abdominal tenderness without rebound, WBC - 8,400 /mm³ and abdominal x-rays unremarkable. Selected images from her abdominal CT performed on this third visit to the ER demonstrate findings consistent with a closed loop obstruction. There is some ascites, a "whirled" appearance to the mesentery and a prominent loop. Surgical exploration found a closed loop obstruction of the distal ileum secondary to a large band like adhesion presumably from the previous c-section. Although the loop was "dusky" in appearance a resection was not necessary as it's appearance improved after relief of the obstruction. The patient had an uneventful recovery.

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