A 30-year-old lady presented through the emergency room with epigastric pain, dark urine, pale stool, and labs showing elevated bilirubin levels. Abdomen ultrasound was requested demonstrating diffusely enlarged hypoechoic liver, with thickened gallbladder wall, pericholecystic fluid and mild splenomegaly. Although non-specific, findings are suggestive of acute hepatitis. Laboratory assessment is recommended for confirmation.