Multiphasic CT imaging confirms a central closed loop small bowel obstruction. This is demonstrated by markedly distended, fluid-filled, small bowel loops, with a whirl sign secondary to the tight mesentery and associated c-shaped small bowel loops. This is identified just above the lumbosacral junction. There is significant free fluid and no free intraperitoneal air. There are non-enhancing small bowel loops suspicious for ischemic bowel.
There are titanium surgical tacks at the lumbosacral junction specifically overlying the anterior inferior L5 vertebral body and sacral promontory. The patient had a prior hysterectomy.
There is incidental bilateral breast augmentation surgery with intact implants in situ.