The ward calls: vomiting and distension

The referral

Medical FY2, 14:15: 'Seventy-six-year-old admitted under us with vomiting, now distended and hasn't opened her bowels for three days. Abdominal X-ray looks dilated. Can surgery review, query obstruction?'

76-year-old, previous open hysterectomy and appendectomy decades ago, hypertension, lives independently.