The small bowel loops appear aggregated on the left side of the abdomen, with abnormal configuration of the superior mesenteric vessels and mesenteric edema. A closed loop obstruction is noted, with the transition point marking the hernial orifice.

The dilated loops are seen posterior to the inferior mesenteric vein, suggesting a left paraduodenal hernia.

Of note, the inferior mesenteric vein drains into the superior mesenteric vein in this patient, which is an anatomical variant.