Antimesenteric small bowel wall trapped inside a small paraumbilical hernia. Herniating wall is thickened, suggesting incarceration*. There are several dilated small bowel loops proximal to the hernia, but no sign of complete obstruction.
Additional findings:
Sternotomy wires
Bilateral ureteral (double J) stents
Small fat-containing left inguinal hernia
Of note, injection of contrast material was avoided due to renal insufficiency.
* The hernia was indeed irreducible at physical examination.