What are gallstones (cholelithiasis)?

Gallstones, also known as cholelithiasis, are solid deposits of digestive fluid in the gallbladder, a small organ that sits just below the liver.

Many people have gallstones without realizing it. Sometimes, however, a gallstone moves into a duct or passageway, creating a blockage so that fluid backs up and the gallbladder becomes inflamed. When this happens, a child may have abdominal pain and nausea, vomiting or fever.

How do gallstones form?

Normally, bile drains from the liver into the small intestine where it helps digest food. Between meals, bile is stored in the gallbladder. Sometimes bile hardens and forms gallstones. Gallstones range in size from small like a grain of sand to the size of a golf ball.

There are different types of gallstones:

  • Pigment gallstones are the most common type of gallstone in children. They form when bile contains too much bilirubin, a byproduct of the body's natural breakdown of red blood cells.
  • Cholesterol gallstones are the most common form of gallstone in adults. (90%) They form when bile mixes with cholesterol and hardens.

What causes gallstones?

Girls are at higher risk than boys of developing gallstones. Other than gender, a number of factors can cause gallstones to form. The most common causes include:

What are the symptoms of gallstones?

Often, people have gallstones but no symptoms, in which case, no treatment is necessary. If gallstones become symptomatic, they typically need to be removed surgically. Symptoms often flare up after meals, especially meals high in fat or grease.

Symptoms include:

  • pain in the upper right stomach
  • nausea
  • vomiting
  • fever

When to seek emergency medical care

If a child with gallstones experiences any of the following symptoms, they need immediate medical care:

  • abdominal pain that is so intense, the child can not get comfortable
  • jaundice (a yellowish tint in the eyes and skin)
  • high fever with chills

How we care for gallstones

Surgeons at Boston Children's Hospital's General Surgery Program  use a minimally invasive procedure called a laparoscopic cholecystectomy to remove gallbladders blocked by gallstones. This surgery allows children to go home the day after surgery and results in considerably less scarring and pain than traditional open surgery.