Case of the Week — January Case #3: Abdominal Pain

25 y/o WM presents to the ED with complaints of periumbilical abdominal pain for 2 days, which is now moved to his RLQ. He denies N/V, F/C. PMHx: Asthma PSHx: none Meds: none Allergies: NKDA Soc Hx: denies ETOH, drugs or tobacco PE: VS: BP 125/70, P 90, R 18, T 98.5 GEN: WNWD, WM, NAD CHEST: CTA B, nonlabored CV: RRR, no M/R/G ABD: TTP RLQ, garding, no rebound, +BS, guiac- EXT: no C/C/E Bedside ultrasound is performed: What is the diagnosis? What is the hyperechoic structure within the lumen? Special thanks to Ruben Font for submitting this case!