**Core Concept**
The clinical presentation suggests **acute pancreatitis**, a condition often associated with chronic alcoholism. The sudden onset of epigastric pain radiating to the back is a classic symptom.

**Why the Correct Answer is Right**
In acute pancreatitis, patients typically present with severe abdominal pain, nausea, vomiting, and may have elevated pancreatic enzymes such as **amylase** and **lipase**. The pain often radiates to the back and worsens after eating.

**Why Each Wrong Option is Incorrect**
**Option A:** Not provided, but typically, options might include symptoms or signs like abdominal tenderness, guarding, or laboratory findings such as hyperglycemia or leukocytosis, all of which can be seen in acute pancreatitis.
**Option B:** Similarly, without the specific option, we might expect to see mentions of complications or associated findings like **hypocalcemia** or **pleural effusion**, which can occur.
**Option C:** Again, without specifics, this could involve discussions around **jaundice** or **Grey Turner's sign**, which are possible but not universal in acute pancreatitis.
**Option D:** Assuming this is the correct choice due to the format requirement, the explanation would hinge on what is "EXCEPT" - implying a symptom, sign, or lab finding not typically associated with acute pancreatitis.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that while **amylase** levels can be elevated in acute pancreatitis, **lipase** is more specific for pancreatic damage and remains elevated for a longer period.

**Correct Answer:** D. No specific option provided to directly answer.