This manuscript describes the incidental diagnosis of Dubin–Johnson Syndrome (DJS), a rare autosomal recessive disorder characterized by impaired hepatic bilirubin excretion and the hallmark appearance of a grossly black liver, in a 34-year-old female who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis. The patient presented with right upper quadrant abdominal pain and mild hyperbilirubinemia. Intraoperatively, the liver was noted to have a strikingly dark pigmentation, prompting a biopsy. Histopathological analysis confirmed the diagnosis of DJS. Additionally, examination of the resected gallbladder revealed focal intestinal metaplasia—an established premalignant lesion associated with an increased risk of gallbladder carcinoma. This report underscores the rare coexistence of DJS and gallstone disease and confirms that the presence of DJS does not complicate laparoscopic cholecystectomy or predispose to postoperative cholestasis. To our knowledge, this is the first documented case of intestinal metaplasia of the gallbladder in a patient with DJS. These findings highlight the importance of routine histopathological evaluation of cholecystectomy specimens, even in cases where DJS is discovered incidentally, to facilitate early detection of potential premalignant changes.
Bekraki et al. (Mon,) studied this question.