A 33 year old man presented with biliary colic and transient obstructive jaundice. In the 4 weeks preceding admission he had been taking a very low calorie diet (the Cambridge Diet) and celebrated achieving his target weight with a fatty meal on the morning of admission. An ultrasound of the gallbladder suggested biliary sludge. We suggest that he developed the biliary sludge as a consequence of calorie restriction and that, following the fatty meal, the gall bladder contracted causing biliary colic and transient obstructive jaundice.
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