Abnormal location of small bowel loops within the left hemi-abdomen, lying in the left anterior pararenal space. The ectopic small bowel is contained within a hernia sac, which is outlined by ascites. Associated stretching and distortion of mesenteric vessels. Findings are consistent with left paraduodenal hernia.
Additionally, some of the small bowel loops demonstrate severe wall thickening and abnormal enhancement pattern consistent with ischemia in the setting of elevated lactate.