History: A 45-year-old male presents to the emergency department with a 12-hour history of severe upper abdominal pain. He describes the pain as constant, sharp, and radiating to his back. The pain started after a large meal, which included fatty foods and alcohol. He rates the pain as 9 out of 10 in intensity. The pain is aggravated by movement and slightly relieved by sitting forward.

He has a history of excessive alcohol consumption (approximately 10 drinks per week for the past 10 years). He denies any recent fever, nausea, or vomiting, but he has had occasional nausea in the past 24 hours. He has no significant past medical history, and his family history is unremarkable.

Physical Examination:

Vital signs: Blood pressure 130/85 mmHg, heart rate 96 bpm, temperature 37.3°C, respiratory rate 18/min.

The patient appears distressed due to pain.

Abdomen: Tenderness in the epigastric region with mild guarding. No palpable masses or organomegaly. Bowel sounds are normal.

No jaundice or signs of peritonitis.

Investigations:

Blood tests: 

Elevated serum amylase (1200 U/L; normal range: 30-110 U/L).

Elevated serum lipase (2000 U/L; normal range: 10-140 U/L).

Mild leukocytosis (WBC: 12,000/mm³).

Liver function tests within normal limits.

Abdominal ultrasound: No gallstones, but the pancreas appears enlarged.

Diagnosis: The clinical presentation and laboratory findings are consistent with acute pancreatitis, likely caused by alcohol consumption.