Patient had history of cervical cancer and radiation therapy, with recurrent small bowel obstructions. The location of thickened small bowel indicates that radiation-related enteritis is the most likely cause of distal small bowel injury and inflammation, resulting in small bowel obstruction. Noticing the typical pattern of marrow loss in the pelvis (L5, sacrum) can be a helpful indicator of the patient's history when the medical records or written history in the order is sparse.