Visceral abdominal adhesions refer to abdominal adhesions that do not involve the anterior abdominal wall and can be inter-intestinal, inter-intestinal and mesenteric, or inter-intestinal between the greater omental mesenteries. These adhesions, unlike wall adhesions that stretch and unfold in the pneumoperitoneal space with the augmentation of the anterior abdominal wall, are buried between the tissues and organs and are indistinguishable from each other in pneumoperitoneal CT imaging, so there is no ideal preoperative diagnostic method and they are a blind spot for imaging. The types of visceral adhesions are diverse and vary greatly, ranging from simple corded adhesions to massed, diffuse complex adhesions, and the ease of surgical release is closely related to the type of pathology. For the exploration of CT imaging diagnosis of abdominal visceral adhesions, I personally believe that efforts can be made in two directions: first, further enrichment of CT scan positions after pneumoperitoneography. The second is the in-depth exploration of the “vortex sign” in abdominal CT images. In the pneumoperitoneum space formed by artificial pneumoperitoneum, the organs are basically not displaced when lying down. In the fully lateral or even prone position, the endopelvic organs, mainly the small intestine, the mesentery and the greater omentum, are displaced in accordance with gravity depending on their free degree, and the pneumoperitoneal space is regularly distributed regionally. Scanning of these alterations is also performed and can provide more information related to the abdominal cavity than in the flat position. The presence or absence of adhesions to intra-abdominal structures will certainly have an impact on this displacement and the morphology of the pneumoperitoneum. Exploring the pattern of displacement and changes in pneumoperitoneum morphology may be a diagnostic imaging clue for visceral adhesions. For example, adhesions of the pelvic wall may be gravity-resistant nonphysiological anatomical structures hanging from the pelvic wall in the complete lateral or prone position. The discomfort is mild in the pneumoperitoneum state in the prone position and significantly increased in the lateral or prone position, but is still safely tolerated within a short scan time. Therefore the outlook of work in this area can be expected. Another possible breakthrough in the diagnosis of visceral adhesions is the interpretation of the “vortex sign” of mesenteric vessels. This sign was proposed mainly as a specific determination of acute intestinal torsion and intra-abdominal hernia on abdominal CT imaging. The mesenteric vessels can be shown to be distributed in a flat scan against a background of adipose tissue, and the contrast is more pronounced when the vessels are injected with enhancer. When the mesenteric vessels are distorted and altered, a characteristic vortex sign may appear. Relevant clinical studies have shown that the swirl sign is also present in non-acute abdominal subjects. The current explanation is abnormalities in the course of the tethered vessels due to tethered adhesions. Therefore, the relationship between tethered adhesions and the swirling sign deserves deeper clinical investigation. The preoperative imaging study of abdominal adhesions combined with the field investigation of clinical laparoscopy will certainly significantly improve our understanding of the imaging diagnosis of abdominal adhesions, especially after the effective intervention of surgical release of adhesions, followed by the review of imaging, which makes the study more thorough and complete and is an objective verification of the relevant findings. After almost a year of waiting, among hundreds of patients, a typical case of pelvic-abdominal intestinal collaterals adhesions finally appeared recently, confirmed by pneumoperitoneography in lateral recumbent scan. It was a pleasure to verify the previous assumptions.