The distended small intestine is indicative of mechanical obstruction because the right colon contains feces (no liquid). A right colon contains liquid contents for most paralytic ileus cases. There is ascites in pelvic cavity of Fig.21 (reference mark), Fig.13-Fig.15 show mesenteric edema (black arrowhead), and distended small intestines are gasless (no gas or small quantity if any) .These 3 findings are suggestive of strangulated small bowel obstruction. In order to confirm closed loop formation, start tracking down distended small bowel from Fig.19. 1 obstructs at 11 of Fig.9, and A at L of Fig.8 indicating closed loop formation, there is collapsed small intestine (SB) in Fig.8. Circle number 1 of Fig.7 progresses to the cephalad side, makes a U-turn in Fig.1 and it makes U-turn in Fig.18 again and continues from circle number 7 to a duodenum in Fig.8. In other words it is strangulated obstruction of jejunum, and excellent enhancement of wall indicates to be viable. The diagnosis was made accurately under CT scan findings, and the patient was taken to surgery. At 50cm from Treitz's ligament, jejunum of about 45cm length was strangulated by an adhesive band forming closed loop. The bowel was mildly ischemic, but improved by severance of band.