Most of distended small bowel are not gasless, but mural enhancement diminishes in comparison with small bowels of Fig.2 and Fig.3. There is a large quantity of ascites in Fig.1-Fig.3 (reference mark), and mesenteric stranding (black arrowhead) of Fig.6 and Fig.7 suggests strangulated obstruction with possible necrosis. Definite diagnosis of strangulated bowel obstruction is made if closed loop formation is proved. Start tracking down from Fig.14, A occludes at G and 1 at 13 of Fig.8 confirming closed loop formation. SB of Fig.8 is collapsed small bowel of caudal side, simple obstruction progresses from circle number 1 of Fig.10 to circle number 6 of Fig.14. Sig:sigmoid colon. Surgery revealed necrotic ileum 55cm in length (Fig. A) at 30cm from cecum, strangulated by an adhesive band.