Solution: Interesting case of a closed loop obstruction in a patient with a misleading history out of the ER. Turns out that he was found moaning and in pain and seemed to have fallen. Thus the history of \"trauma\". The scan does show free fluid which might lead you to believe that there is a solid organ injury, but none was present. However, there was an isolated grouping of small bowel with dilatation and poor mucosal enhancement, consistent with a closed loop obstruction. The free fluid raises concern for possible rupture and the infiltration of the mesenteric fat reflects at least venous congestion and possible arterial compromise as well. This patient went directly to surgery and had a closed loop obstruction secondary to an adhesion with dead bowel, but no rupture.

Incidentally noted was an annular pancreas.