Classic "C-loop" configuration indicating a closed-loop small bowel obstruction. Closed loop obstructions with dilated upstream small bowel can be particularly challenging because unless you run the small bowel, you may not detect that there are two transition points. In this case, the two transition points into and out of the closed "C-loop" in the RLQ are best seen on coronal images (although sagittal are also worth reviewing to help understand the anatomy). In challenging bowel cases, it is essential to review all planes to help you understand the anatomy and boost your diagnostic confidence. This patient proceeded to surgery and a closed loop obstruction due to adhesive band with small bowel ischemia was identified, resulting in resection of small bowel and prolonged postoperative course.