A 32-year-old woman presented with generalized colicky abdominal pain, bilious vomiting and constipation of 1-day duration. She had no history of abdominal surgery or constitutional symptoms of chronic illness such as tuberculosis, inflammatory bowel disease or malignancy. She had been married for more than 10 years and has one child. Her vital signs were normal. Complete blood count, liver and renal function tests, erythrocyte sedimentation rate and C-reactive protein levels were normal. Abdominal examination revealed diffuse distention with hyperactive bowel sounds; there were no hernias or signs of peritonitis. The clinical impression and plain abdominal X-ray findings were consistent with subacute SBO. Initially, the patient improved on conservative management of nil by mouth, intravenous (IV) fluids and nasogastric tube (NGT) decompression. Abdominal computerized tomography scan with water-soluble contrast through NGT revealed dilated loops of small bowel, left hydrosalpinx and contrast reaching the colon. The patient underwent laparoscopic intervention because of persistence of her symptoms and to establish the underlying cause. Laparoscopic findings were multiple small bowel adhesions (mainly ileal), "violin string" adhesions between the liver and anterior abdominal wall, free peritoneal fluid and left hydrosalpinx [Figure 1]. Laparoscopic adhesiolysis was performed using endoshears and diathermy [Figure 1]. Swab samples were initially taken from the peritoneal fluid and later from the uterine cervix to test for Neisseria gonorrhoeae and Chlamydia trachomatis. Swabs and serology for both organisms were negative. Gynecological consultation was sought, and no antibiotics were recommended because the patient did not have active PID. The patient had an uneventful recovery and was discharged 5 days after surgery. Two months later, she remained symptom-free when seen at the outpatient clinic.