Question

An 85-year-old woman presents to the emergency department with nausea, emesis, abdominal distention, and obstipation. A CT scan demonstrates a small bowel obstruction with a transition point in a hernia defect in the right obturator foramen. There are no signs of bowel ischemia. On exam, she is afebrile with hypotension and tachycardia that resolves immediately with fluid resuscitation. Her abdomen is distended but nontender. There is no rebound or guarding. The best next step in management is

          An 85-year-old woman presents to the emergency department with nausea, emesis, abdominal distention, and obstipation. A CT scan demonstrates a small bowel obstruction with a transition point in a hernia defect in the right obturator foramen. There are no signs of bowel ischemia. On exam, she is afebrile with hypotension and tachycardia that resolves immediately with fluid resuscitation. Her abdomen is distended but nontender. There is no rebound or guarding. The best next step in management is

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