Gallstones (cholelithiasis) are small hard pellets that form when bile (a digestive fluid made by the liver) begins to harden as it is stored in the gallbladder. Gallstones may also form from cholesterol and broken down blood cells. Biliary dyskinesia happens when the gallbladder does not squeeze hard enough to push all of the bile contents into the small intestine. When bile remains in the gallbladder, it can crystalize and form gallstones. Biliary dyskinesia can also exist without gallstones.
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:
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.
Pediatric surgeons and gastroenterologists at Riley at IU Health perform the following exams and tests to diagnose gallstones and biliary dyskinesia:
The treatment goal for gallstones and biliary dyskinesia is to relieve pain. Options include:
Visit the links below to find support groups and services and learn more about gallstones and biliary dyskinesia.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
Pediatric surgeons and pediatric gastroenterologists at Riley at IU Health completed and presented a study about the use of HIDA scans and gallbladder removal to treat biliary dyskinesia. Not all children are cured with surgery, and researchers are looking for ways to relieve the pain that remains after gallbladder removal.
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