A 50-year-old man presented with crampy abdominal pain, nausea and vomiting. He had no history of abdominal surgery and no hernia on physical exam. There was a distended abdomen with hyperactive bowel sounds, diffuse mild tenderness but no guarding or rebound. Rectal exam was normal. Upper GI series showed dilated small bowel, primarily jejunum (plicae semicircular) with complete obstruction.