A four month old Appaloosa filly presented to the Cornell University Equine and Farm Animal Hospital on an emergency basis with a one day history of colic. The foal had been inappetent and pawing at her hay in the morning and a few hours later was sweating, kicking at her abdomen and rolling. On presentation, the foal was quiet and slightly depressed but was not trying to kick or roll. Vital signs were all within normal limits and physical exam was unremarkable aside from decreased gut sounds in all four quadrants. Point of care abdominal ultrasound revealed distended, amotile small intestine but a small stomach and no obvious foreign body or intussusception. Overnight, the foal had a few episodes of discomfort and rolling. Fluid obtained from abdominocentesis was abnormal, but changes were not significant enough to warrant emergency surgery. Abdominal ultrasound the next morning revealed further distended loops of bowel filled with fluid and live ascarids. The foal was taken to surgery for a suspected ascarid impaction; however, exploratory laparotomy revealed a small loop of jejunum entrapped in a diaphragmatic rent. A resection and anastomosis was performed on the affected area of jejunum and the diaphragmatic rent repaired. On the 11th day post-op, the foal showed signs of colic which were not able to be alleviated with pain medication and the foal was euthanized. Necropsy results showed many adhesions around the previous anastomosis site, adhesions to the incision site on the ventral body wall, and an additional rent in the diaphragm with entrapped liver and a deep incisional abscess.