The crystal structure of the title compound is the first example of a bilirubin existing in both extended and cyclic conformations and the first bile pigment structure showing two markedly different conformations in the unit cell. In contrast to previous rubin structures the dipyrrinone rings are twisted out of planarity in both conformers. Because of numerous hydrogen-bonding and ionic interactions a highly complex tetrameric structure is observed in which each extended conformer is held pincer-like by another.