A complicated SBO in a 69-year-old male with gastric cancer and peritoneal carcinosis. Ultrasound images show long (a) and axial (b) evaluations of a fluid-filled, dilated small bowel loop with hyperechogenic floating material (shown with an asterisk) (b,d). Bowel peristalsis was absent. Mild parietal and valvulae conniventes thickening are present (c,d). Downstream loops present normal caliber (bowel jump diameter). Free fluid is interposed between bowel loops (black arrow) (b).