A 57-year-old woman with diabetes and hypertension presented with acute calculous cholecystitis and cholangitis. Incidentally, two splenic lesions were identified on formal abdominal ultrasound, one demonstrating the sonographic bright band sign. Computed tomography confirmed splenic infarctions and also revealed portosplenic vein thrombosis. Haematological workup, including JAK2 V617F mutation analysis, led to a diagnosis of polycythaemia vera, contributing to cholelithiasis via increased cell turnover and thrombosis due to hyperviscosity. She was started on venesection and hydroxycarbamide and discharged well. However, she defaulted follow -up and re -presented two years later with disseminated intravascular coagulation, eventually succumbing to the illness. This case highlights the utility of the sonographic bright band sign in identifying splenic infarction and distinguishing it from other hypoechoic splenic lesions

A 57-year-old woman with diabetes and hypertension presented with acute calculous cholecystitis and cholangitis. Incidentally, two splenic lesions were identified on formal abdominal ultrasound, one demonstrating the sonographic bright band sign. Computed tomography confirmed splenic infarctions and also revealed portosplenic vein thrombosis. Haematological workup, including JAK2 V617F mutation analysis, led to a diagnosis of polycythaemia vera, contributing to cholelithiasis via increased cell turnover and thrombosis due to hyperviscosity. She was started on venesection and hydroxycarbamide and discharged well. However, she defaulted follow -up and re -presented two years later with disseminated intravascular coagulation, eventually succumbing to the illness. This case highlights the utility of the sonographic bright band sign in identifying splenic infarction and distinguishing it from other hypoechoic splenic lesions