Ultrasonography has become the first imaging modality in obstructive j
aundice; it has the ability to define the cause and level of obstructi
on [1-3]. The most common causes depend on the population studied and
include neoplasm (ranging from 18 to 86%) [1-3], calculous disease (va
rying from 5 to 48%) [1-3], and pancreatitis (in 2-27% of patients stu
died) [1-3]. Recently, we encountered a diagnostic challenge of a pati
ent in whom silent obstructive jaundice developed, which proved to be
of an etiology not previously reported.