February Case #1: RUQ pain

49y/o WF presents to the ED with complaints of abdominal pain, nausea and vomiting since last pm. She states that she has had similar episodes in the past, but none have lasted this long. She denies F/C
PMHx: none
PSHx: none
Social Hx: none
Meds: none
Allergies: NKDA

PE:
VS: BP121/53, P87, R18, T 98.7, Pox 98% (RA)
GEN: Obese, WF, appears uncomfortable
CHEST: CTA B, nonlabored
CV: RRR, no M/R/G
ABD: soft, obese, +TTP RUQ, +Murphy's sign, no rebound, no guarding, +BS
EXT: no C/C/E

Bedside US is performed with the following findings:


What is the diagnosis?
What sonographic sign is featured?