The patient’s symptoms (nausea & vomiting, abdominal distension, absent bowel sounds and anuria) are suggestive of intestinal obstruction CITATION Cha03 \l 1033 (Kahi & Rex, 2003). The increase in weight is due to third space fluid shift occurring secondary to inflammation due to intestinal obstruction CITATION Red01 \l 1033 (Redden & Wotton, 2001) and the abdominal distension could be either due to intestinal obstruction or secondary to bladder distension due to urinary retention (UR). UR occurred as a side effect of one of her medications. Anticholinergic agents such as Oxybutynin (Ditropan) have an established role in the etiology of UR as they reduce the contractility of the bladder detrusor muscles and Metoclopramide (maxalon) has also been found to cause UR CITATION Dra98 \l 1033 \m Bri08(Drake, Nixon, & Crew, 1998; Selius & Subedi, 2008).

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