A 48-year-old female with a past medical history of opioid use disorder on suboxone presents with abdominal pain for one day. The patient developed sharp diffuse upper abdominal pain the evening prior to arrival that resolved. The pain recurred again today and was associated with bilious emesis. The patient notes persistent upper abdominal pain with paroxysmal exacerbation. She has a history of a hysterectomy, but no other abdominal surgeries. No history of gallstone pathology.