Gallstones & Biliary Dyskinesia

About 2 percent of children have gallstones. Gallstones in babies and young infants are often related to prematurity and other existing conditions, such as jaundice, cystic fibrosis or prolonged use of intravenous feeding. Gallstones go away without treatment in about 20 percent of infants with the condition.

The frequency of gallstones in older children has increased due to a rise in obesity and better ultrasound detection technology. Obesity can lead to gallstones, because when bile cannot dissolve all of the cholesterol in the body, the cholesterol and bile can form a stone.

Gallstones are more common in children with sickle cell disease or other conditions that cause a break down of blood cells. Children with sickle cell disease are more likely to develop gallstones as they get older.

Symptoms of gallstones and biliary dyskinesia often begin with pain in the right upper abdomen. Other symptoms may include:

• Fever
• Jaundice (if a gallstone blocks a bile duct)
• Nausea
• Pain with eating
• Pain after meals
• Vomiting

Gallstones may dissolve or travel out of the gallbladder, into a bile duct and pass out of the body. When gallstones require treatment, pediatric surgeons can remove the gallbladder. Gallstones usually do not come back after treatment. Sometimes pain remains after treatment for biliary dyskinesia. When this happens, doctors will look for other causes, such as conditions of the liver or pancreas.

Diagnosis of Gallstones & Biliary Dyskinesia

Pediatric surgeons and gastroenterologists at Riley at IU Health perform the following exams and tests to diagnose gallstones and biliary dyskinesia:

• Clinical exam. A doctor will examine your child’s abdominal area. He or she will talk with your child to locate the pain and determine when it occurs.
• Ultrasound. This test uses sound waves to create images of the gallbladder and bile ducts. This painless exam can show where gallstones are located in the biliary tree.
• Hepatobiliary iminodiacetic acid (HIDA) scan. A HIDA scan uses a radioactive chemical to trace the path bile takes from the liver to the gallbladder and into the small intestines. A nuclear medicine camera follows the flow of the chemical agent through your child's body. This helps the doctor see how well the gallbladder contracts and whether any gallstones or blockages exist.