This is an 83-year old woman with a history of prior abdominal surgeries presenting to the ED as a transfer from her SNF with increasing abdominal distention. Patient has not had a bowel movement in four days although endorses passing occasional flatus. She denies emesis though endorses nausea, hiccupping, and burping. She denies any abdominal pain, fevers, chills, dysuria or urinary frequency. ..