Male patient 65 years old presented to our ER complaining of abdominal pain and absolute constipation

Male patient 65 years old presented to our ER complaining of abdominal pain and absolute constipation to flatus and stools since 3 days associated with nausea and vomiting and anorexia

the condition started since 3 days with vague abdominal pain associated with nausea vomiting and anorexia
patient soak medical care at internal medicine doctor and diagnosed at time as a vague abdominal pain with gastritis

patient is is hepatic since 10 years on hcv follow-up protocol

x-ray abdomen was done showed multiple air fluid level
CT with IV contrast show with transitional zone on small bowel
What do u think …???