Gallstones

 What are gallstones?

Gallstones are solid deposits of digestive fluid in the gallbladder, a small organ that sits just below the liver. Although the condition is more common in adults, about 2 percent of children of children are diagnosed with gallstones. Another word for gallstones is cholelithiasis.

Many people have gallstones without realizing it. Sometimes, however, the gallbladder becomes inflamed or a gallstone moves into a duct or passageway, creating a blockage. When this happens, a child may have abdominal pain and nausea, vomiting and/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. 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 in children include:

  • abnormalities in the production of red blood cells
  • prolonged fasting due to illness
  • use of contraceptives
  • pregnancy
  • long-term parenteral nutrition

 What are the symptoms of gallstones

Often, people have gallstones but no symptoms. If gallstones become symptomatic, the gallbladder typically needs to be removed. Symptoms often flare up after meals, especially meals high in fat or grease.

Symptoms include:

  • pain in the upper right abdomen
  • 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)
  • fever with chills

 How we care for gallstones

The Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital will assess your child’s symptoms and order appropriate tests to determine the severity of the gallstones. Depending on the test results, we will determine the best course of treatment for your child with a team of physicians.

 If your child has symptomatic gallstones that require surgery, surgeons in our will use a minimally invasive procedure called a laparoscopic cholecystectomy to remove the blocked gallbladder.