The aim of this study was to clarify the usefulness of reconstructed images made from arterial phase images in contrast computed tomography (CT) scans of strangulation ileus in order to make an early diagnosis of bowel ischemia. We have previously reported on the utility of the arterial phase of CT for detecting intestinal ischemia associated with strangulation ileus. Based on the results of that previous study, we made a reconstructed image (ileus mode) that emphasized the ischemic part of the bowel in patients with strangulation ileus. From the results of the interpretation of the ileus mode by three trained surgeons, the diagnostic performance was thus analyzed. The accuracy was 88%, and the sensitivity and negative predictive value were 100% for two of the three surgeons. These findings suggest that reconstructed images from the arterial phase of multi-detector row CT scans demonstrated excellent visibility of the ischemic site in strangulation ileus patients, and they may therefore be useful for making an accurate diagnosis of intestinal ischemia.