The reasons for this are that the bowel loops involved being in a closed space the signs of

generalized peritonitis do not appear until very late and moreover when CT is requested
subtle signs of internal hernia like crowding of the bowel loops in one portion of
peritoneal cavity and displacement of neighboring structures due to mass effect and
features of incomplete bowel obstruction which are early features are often missed by the
radiologist mainly because the possibility is not kept in mind.