Small intestine is distended, and right colon does not contain fluid suggesting small bowel mechanical obstruction. Gasless distension of small bowel and ascites between mesentery (Fig.4-Fig.9: black arrowheads) strongly suggest strangulated obstruction. On tracking down starting with Fig.12, 1 blocks up at 29 of Fig.2, and A at K of Fig.2 indicating closed loop formation. There is a collapsed small intestine (SB) of caudal side in Fig.2. Circle number 1 of Fig.2 is the origin of cephalad simple obstruction and becomes circle number 10 of Fig.1(same number as long as it goes up and down). Wall of closed loop is well contrast-enhanced suggesting no necrosis at the time of CT examination. The surgery was undertaken six hours after the CT scan was obtained and it revealed closed loop formation with necrosis of 100cm ileum by an adhesive band. Immediate surgery after accurate CT diagnosis would have avoided unnecessary excision of small bowel.