Multiple loops of dilated small bowel indicate small bowel obstruction. These loops can be seen down to the level of a large round density in the central abdomen. This appearance is occasionally seen in obstruction due to an umbilical hernia.
Gas in the rectum suggests the obstruction is not absolute.
This sagittal plane CT image shows the cause of the round area of density seen on the image above. The image clearly demonstrates the defect in the anterior abdominal wall and herniation of bowel and ascitic fluid.