Preschooler with nausea and vomiting who had a congenital diaphragmatic hernia repaired 4 years ago

AXR of small bowel obstruction due to abdominal adhesions
AXR supine (left) shows multiple dilated loops of small bowel that have a stacked appearance. AXR upright (right) shows multiple air fluid levels within those loops of small bowel.

The diagnosis was abdominal adhesions from the prior surgery causing a distal closed loop small bowel obstruction.