A male pt aged 44 years p/w complaints of Pain Abdomen and Vomitings (Multiple) since 2 days... He also had 1 episode of Fever and severe constipation... comment on his Xray and discuss the causes of his symptoms

A male aged 45 years who is a chronic alcoholic *Chief Complaints* Acute onset Pain Abdomen Epigastric, radiating to back Poorly localized *Physical Examination* P/A - Distended, BS(-)

61/Female known dm. Presented with Epigastric Pain Attached Ecg known Hypothyroidism on Treatment Attached ECG

41 year old male patient asymptomatic 2days ago, then developed diffuse pain abdomen, more at epigastric region, epigastric tenderness present, and also complain pain at rt flank , no radiation, no burning micturition, no constipation, h/o vomiting present 2 episodes, no htn, no DM, chronic alcoholic, vitals are normal.. Usg abd: Rt renal calculus 4.5mm, and mild hepato megaly noted . On day 1 : Sr.Amylase 198IU/L, on day 2: sr Amylase 526 IU/L, And the treatment is as follows: Pt is under NBM 1.Inj .Monocef +sulbactum /iv/bd 2. inj . pantaprazole /iv/bd 3. inj. Buscopan /iv/sos 4.inj. 25% D /iv/bd 5 ivf. 2 units of 0.9% NS 2 units of RL 1 unit of DNS over 24 hrs. admitted on 13th May, today complaint is SOB, on auscultation lungs are clear, ECG ::. sinus tachycardia given Metaprolol 50mg, after giving metaprolol HR comes down. Wt is the cause of SOB, and cause of sudden raised sr.amylase. Help me in this case::

34y female pt suffering with sever pain abdomen and. vomiting fever please suggested further evaluation and treatment