Case Presentation: A 49-year-old male with past medical history of alcohol use disorder, hypertension, and necrotizing pancreatitis presented with severe epigastric pain for one day. The pain was sharp, non-radiating, worsened by eating, and associated with nausea and diarrhea. He drinks a fifth of hard liquor daily. Pertinent labs showed bicarbonate 8 with an anion [...]