A 46-year-old man comes to the physician for a follow-up examination. Two weeks ago, he underwent laparoscopic cholecystectomy. During the procedure, a black liver was noted. He has a history of intermittent scleral icterus that resolved without treatment. Complete blood count is within normal limits. Liver function studies are as follows: Which of the following is the most likely cause of this patient's finding?

Question

A 46-year-old man comes to the physician for a follow-up examination. Two weeks ago, he underwent laparoscopic cholecystectomy. During the procedure, a black liver was noted. He has a history of intermittent scleral icterus that resolved without treatment. Complete blood count is within normal limits.  Liver function studies are as follows:  Which of the following is the most likely cause of this patient's finding?

Quizplus · Accepted Answer

Eductional Objective: Dubin-Johnson syndrome is a benign disorder characterized by defective hepatic excretion of bilirubin glucuronides across the canalicular membrane, resulting in direct hyperbilirubinemia and jaundice.  Grossly, the liver appears black due to impaired excretion of epinephrine metabolites, which histologically appear as dense pigments within lysosomes.

A 46-Year-Old Man Comes to the Physician for a Follow-Up