A 78-year-old woman comes to the emergency department with a long history of chronic constipation and obstipation, nausea, abdominal pain, and distention for the past 5 days. Physical examination reveals abdominal distention with bilateral lower abdominal discomfort and fullness. On digital rectal examination, fecal impaction is noted and an attempt at manual disimpaction is unsuccessful. Computed tomography shows the findings in the Figure. The best next step in management for this patient is:

question 109

Emergency Imaging, MDedge Emergency medicine