Ileus Quiz: Ace Your Exams

A 52-year-old man presents to the emergency department for evaluation of worsening abdominal pain and distension over the past 3 days. He has not had a bowel movement over this period of time.  He had a severe lumbar sprain 2 weeks ago and was prescribed medications for pain control. Temperature is 37 °C (98.6 °F), heart rate is 82/min, respiratory rate is 16/min, blood pressure is 120/80 mmHg, and oxygen saturation is 98% on room air. On examination, the abdomen is distended and tympanic to percussion with decreased bowel sounds on auscultation. The scout CT image is displayed below. Which of the following would be most consistent with the suspected diagnosis?
 
^{Image courtesy of Radiopaedia}