Gallstones are hardened accumulations of chemicals in the gallbladder. They form through a process called cholelithiasis, and generally range from a few millimeters to a few centimeters in diameter, notes the University of Maryland Medical Center, or UMMC. While the exact causes of gallstones are unknown, there are risk factors associated with their development. Gallstones are not uncommon in adults, affecting about 25 million in the United States annually, but they are fairly rare in children.
Types
Most gallstones are made up predominantly of cholesterol, calcium carbonate or pigment called calcium bilirubinate. The rates of occurrence are different in children than in adults, as the study "Calcium Carbonate Gallstones in Children" found. While cholesterol stones make up around 75 percent of adult stones, they account for less than 25 percent in children. Pigment stones, the second most-common type in adults and children, account for around 15 and 20 percent, respectively. Calcium carbonate stones are rare in adults, accounting for only about 4 percent of stones. This type is significantly more common in children, accounting for about 25 percent of childhood gallstones. Around 5 percent of children have protein gallstones.
Risk Factors
Although adult women are far more likely to develop gallstones than adult men, occurrence in children is about equal, notes UMMC. Obesity, congenital blood disorders such as spherocytosis or sickle cell disease and a family history of gallstones put a child at increased risk of developing the condition, according to Seattle Children's Hospital, or SCH. A high-fat, high-cholesterol or low-fiber diet increases risk as well, explains MayoClinic.com.
Symptoms
Some gallstones produce no symptoms, but when they do, symptoms are usually sudden, says SCH. Pain in the upper right or middle right section of a child's abdomen or back is a primary symptom of gallstones, according to Children's Hospital Boston. The pain, which also sometimes manifests between the shoulder blades or in the right shoulder, usually lasts about half an hour, and often presents after eating, especially following fatty or greasy meals. Gallstones that obstruct a child's bile duct may also cause nausea, vomiting, fever and jaundice, adds SCH.
Diagnosis
A child's pediatrician may suspect gallstones based on the location, frequency, severity and duration of pain, and if it has notable triggers such as high-fat meals. The pediatrician may recommend the child see a gastroenterologist. An abdominal ultrasound or a CT scan can provide images of the gallbladder that reveal stones. Further testing, such as an MRI or HIDA scan, may be necessary to determine whether there is any obstruction in a child's bile ducts. Blood tests can check for other gallstone complications, such as an infection, jaundice or pancreatitis.
Treatment
If a child's gallstones produce no symptoms, and if no complications or duct blockages are detected, the stones require no treatment, according to SCH. In other instances, the only treatment for a child's gallstones is removal of the gallbladder with a procedure called a cholecystectomy. The procedure is performed under general anesthesia, usually laproscopically, with four incisions in the abdomen. It typically has no permanent effect on a child's quality of life, as a gallbladder is unnecessary. Painkillers may be prescribed to treat symptoms until the operation is performed.
