Only small bowel is distended and right colon contains no fluid indicating small bowel mechanical obstruction. There is ascitic fluid (reference mark) in Fig.1-Fig.3. Fig.9-Fig.12 show fluid collection (black arrowheads) between mesentery. Distended small bowel in lower abdomen is gasless suggesting high possibility of strangulated obstruction. In order to prove closed loop formation, start tracking down A and 1 of Fig.14. A is traced to obstruction site at P of Fig.8, and 1 to obstruction point 19 of Fig.6 showing beak sign (black arrow). Fig.7 and Fig.8 show collapsed small bowel (SB) and simple obstruction starts at circle number 1 of Fig.7. Surgery revealed necrotic 60cm ileum strangulated by an adhesive band.