Blocked up!

An abdominal X-ray is performed and shown below.

Case courtesy of Radswiki, Radiopaedia.org. From the case rID: 11177

What is the main abnormality observed?

Laboratory blood tests are performed and show:

Hb 120 g/L (115 – 160)

MCV 90 (82 – 100 fl)

PLTs 410 (150 – 400 * 10⁹/L)

WCC 5.2 (4.0-11.0 * 10⁹/L)

Serum Na+ 133 (135 – 145 mmol/L)

Serum K+ 2.9 (3.5 – 5.3 mmol/L)

Urea 4.3 (2.0 – 7.0 mmol/L)

Creatinine 90 (55 – 120 umol/L)

CRP 50 (<5 mg/L)

Which medication would NOT contribute to this abnormal finding?

From the investigations, you suspect a paralytic ileus from hypokalaemia. Although rare, you have excluded any mechanical causes of the obstruction and await a general surgery review.

What important interventions can you initiate in the meantime?