This patient has a bowel obstruction, what type is it?
Given that both the large and small bowel are dilated, it is going to either be a large bowel obstruction or paralytic ileus (pseudo-obstruction).
What is the next most appropriate management?
Symptomatic relief (pain relief, IV fluids, nasogastric tube). The cause of the bowel obstruction needs to be determined, and CT should be performed.
The entire colon is dilated and gas filled with the caecum measuring up to 10 cm in maximal diameter. Multiple air fluid levels seen on the erect film. Gas filled loops of small bowel are identified.