The erect abdominal x-ray shows dilated loops of small bowel and multiple air fluid levels. X-ray appearance is suggestive of small bowel obstruction. A CT scan showed obstructed infra umbilical hernia.

Plain radiographs have a sensitivity of 66 % for small bowel obstruction. If there is a strong clinical suspicion, CT scan is the imaging modality of choice to confirm SBO and to identify the cause.

Reference: Grainger & Allison’s Diagnostic Radiology.