Well done. Dilated bowel loops brings it down to the old obstruction vs ileus differential. But don’t wimp out. Use all your information to see if you can determine between the two. In this case we have a fairly disorganized appearance to the dilated, nearly all air filled, bowel loops. Plus there is plenty of air in the colon (all the way to the rectum). And, as many noticed, there are midline surgical clips.

Answer: postoperative adynamic ileus

Reference: http://radiopaedia.org/articles/adynamic-ileus