Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 06 08 1608 1608 Sonal Khatavkar Department of Anesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India. Sircilla Kumar Department of Anesthesiology, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India. 2026 03 29 2026 05 10 Hereditary spherocytosis (HS) is a hemolytic disorder in which perioperative stress may exacerbate hemolysis. We report the anesthetic management of a 16-year-old male with HS undergoing cholecystectomy under general anesthesia with epidural analgesia. Postoperatively, there was a transient rise in bilirubin levels without a corresponding fall in hemoglobin or clinical evidence of hemolysis. The patient remained hemodynamically stable and improved with supportive management. This case highlights that postoperative hyperbilirubinemia in HS patients is not always indicative of hemolytic crisis and should be interpreted in the appropriate clinical context. https://aacc.tums.ac.ir/index.php/aacc/article/view/1608