Internal hernia is a rare cause of small bowel obstruction; even more rare is one that occurs through a sigmoid epiploica defect. There have been only two previously reported cases from this etiology, but both were without the advantage of high-resolution imaging. We report the first color representation of this pathology, along with the first video recording of the internal hernia reduction. While this is a rare case, it is an important diagnosis to consider in the differential for patients presenting with a small bowel obstruction, with no previous abdominal surgeries or clinical findings of extra-abdominal hernias.