The AP scout image shows distended bowel within the left upper quadrant.
Fluid distension of the biliopancreatic limb (stomach, duodenum, and jejunum), with two separate transition points in the left upper quadrant seen as abrupt narrowing of the small bowel with a twisting configuration of the adjacent mesentery. The transition points are proximal to the distal jejunojejunal anastomosis and the alimentary limb is not dilated. No free fluid or free air.
The appearances are consistent with a closed-loop configuration of small bowel obstruction, with the most likely aetiology being an internal hernia and associated volvulus, with additional consequent obstruction of the upstream stomach, duodenum and jejunum.
Dilatation of the common bile duct is also noted.