An estimated 15% of emergency department (ED) patients admitted to a surgical unit with abdominal pain are ultimately diagnosed with small bowel obstruction (SBO) (1). The work up of patients with possible SBO is directed by the patient history, physical examination and pre-test probability. Relatively insensitive abdominal x-rays (AXR) are commonly ordered as a screening test, but computed tomography (CT) imaging is often necessary to confirm or exclude the diagnosis of SBO. This diagnostic process is time consuming, costly and exposes the patient to ionizing radiation.