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Gallbladder disease is one of the most common gastrointestinal tract diseases. In obstructive jaundice, there is a reduction in bile flow out of the liver secondary to the blocked bile or pancreatic duct, which leads to excess bile and its products accumulating in the blood. One of these products is lipoprotein X (LpX); its presence is associated with a lipoprotein pattern characterized by an increased concentration of low-density lipoprotein (LDL) cholesterol. Few published articles have reported the association between obstructive jaundice and hyperlipidemia. This report describes a unique case of a Saudi female patient diagnosed with obstructive jaundice, presenting with extreme hypercholesterolemia, which was reduced significantly 1 week after endoscopic retrograde cholangiopancreatography (ERCP). Correct recognition and investigation of the lipid profile are important for differentiating LpX-mediated hypercholesterolemia caused by obstructive jaundice from other causes of elevated LDL concentrations. Differentiation may affect the patient's therapeutic management.

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