A Black Liver During Laparoscopic Appendectomy: Incidental Diagnosis of Dubin-Johnson Syndrome

Dubin-Johnson syndrome (DJS) is a rare, benign autosomal recessive disorder that involves chronic conjugated hyperbilirubinemia and a distinctive black pigmentation of the liver.It is typically asymptomatic and often discovered incidentally.We report a case of a 23-year-old male patient who presented with acute appendicitis and mild jaundice.Laboratory work-up found isolated conjugated hyperbilirubinemia with all other liver enzymes normal.Laparoscopic appendectomy was performed, and the liver was found to be diffusely black with a smooth surface, which led to suspicion of underlying hepatic pathology.Postoperative clinical evaluation and family history supported the diagnosis.This case highlights the importance of recognizing DJS intraoperatively to avoid unnecessary diagnostic and surgical interventions.