The patient is a 75-year-old gentleman who presents to ED the complaining of complaining of epigastric pain. The pain has been present for over a week with no nausea, no vomiting pain. It comes and goes over the past 5 months. The pain is worsened lately and it covers about 2-3 hours after eating. The patient is passing flatus and having BMs. His medical history is significant for cirrhosis secondary to alcohol abuse. He has a history of variceal bleeding and a TIPS procedure in 2015, congestive heart failure, coronary bypass grafting, hypertension, and acute on chronic diastolic heart failure. Ultrasound done at time of admission reveals cirrhotic liver with a patent TIPS in place and his gallstones with no biliary duct obstruction.