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This is a rare case of malrotation with proximal small bowel volvulus (whirlpool sign) & associated intestinal occlusion in an adult patient. This patient actually had intermittent abdominal pain for a few months, and the obstruction looks chronic / sub-obstructive since per os contrast migrated normally in the distal small bowel.
Most of the small bowel is located to the right and large bowel to the left, even though the transverse colon crosses the midline to the right. The relation between the superior mesenteric artery & vein is abnormal, the latter being located to the left proximally - it is swirling after.