A 56-year-old female presented to the emergency department with abdominal pain. She developed continuous pain in her upper abdomen 24 hours earlier, which has been progressively becoming severe. The pain is radiating to her back.

She is feeling nauseated and cold and hot alternatively. History: Treatment of duodenal ulcer five years ago using Helicobacter eradication therapy Smokes 15 cigarettes per day Consumes half bottle of wine each evening Examination: Unwell, dehydrated, and febrile Temperature: 38.5◦C Pulse: 108/min Blood pressure: 124/76 mmHg Cardiovascular and respiratory examinations: Normal Tender at right upper quadrant and epigastrium, with guarding and rebound tenderness Bowel sounds: Sparse Investigation:                                                                            Test value                          Normal value Haemoglobin                                 …