{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:00:10Z","timestamp":1762941610018,"version":"3.45.0"},"reference-count":11,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,23]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>A man in his late 20s presented to the emergency department with 4\u2009months of progressive colicky pain, suspected of cholecystolithiasis. Abdominal ultrasonography confirmed the presence of gallstones. Laboratory tests showed no abnormalities. Due to the severity of his symptoms, an emergency laparoscopic cholecystectomy was scheduled. Diffuse intra-capsular, solid, oval, white lesions were observed on the liver intraoperatively. Histological analysis showed granulomatous inflammation consistent with sarcoidosis. Chest CT scan showed mediastinal and hilar lymphadenopathy, also suggestive of sarcoidosis. Because of persistent abdominal pain and the absence of cirrhosis, a laparoscopic cholecystectomy was performed, resulting in the resolution of symptoms. In conclusion, the symptoms of sarcoidosis show a great variety depending on the organs involved. So, when gallstone disease is suspected but atypical findings are observed, it is important to consider the possibility of an alternative underlying cause such as hepatic sarcoidosis, requiring different treatment strategies and follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2025-267941","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:55:13Z","timestamp":1762941313000},"page":"e267941","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Two diagnoses, similar clinical presentation: unexpected hepatic sarcoidosis during laparoscopic cholecystectomy"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1508-6335","authenticated-orcid":false,"given":"Maureen","family":"Heijne den Bak","sequence":"first","affiliation":[{"name":"Surgery, IJsselland Hospital, Capelle aan den IJssel, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0033-9947","authenticated-orcid":false,"given":"Carlijn","family":"Witjes","sequence":"additional","affiliation":[{"name":"Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Colorectal Surgery, IJsselland Hospital, Capelle aan den IJssel, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ragni","family":"Chauthie","sequence":"additional","affiliation":[{"name":"Gastroenterology, IJsselland Hospital, Capelle aan den IJssel, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen","family":"van Vugt","sequence":"additional","affiliation":[{"name":"Surgery, University Medical Centre Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"2025111201550662000_18.11.e267941.1","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1002\/hep.1840080433","article-title":"The epidemiology of gallstone disease in Rome, Italy. 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