Antecolic roux-en-Y gastric bypass. Oral contrast extends into the mid/distal small bowel without obstruction. The proximal jejunum just beyond the ligament of Treitz has a swirled/clustered appearance with minor proximal mesenteric edema and slight enlargement of lymph nodes. Narrowing and swirled appearance of the superior mesenteric vein with multifocal narrowing of its small bowel branches. Focal narrowing of the proximal SMA as it swirls. Notice how all of the small bowel is midline or left midline. The terminal ileum is stretched leftward across midline toward the clustered nonopacfied small bowel.