Cholelithiasis (Gallstones)

What are the signs and symptoms of gallstones?

Some people with cholelithiasis, or gallstones, have no symptoms. When symptoms of gallstones do appear, they include:

• Pain in the upper right or upper middle abdomen, especially after eating high-fat foods
• Nausea, vomiting or fever
• Jaundice (yellowing of skin or eyes)
• Dark urine or light stools

What tests are used to diagnose gallstones?

If your child’s doctor suspects gallstones, they will perform a physical exam and consider your child’s symptoms and medical history. Gallstones are usually diagnosed using imaging tests that show the size, number and location of stones. These tests include:

• An ultrasound is a fast, noninvasive imaging test that uses sound waves to create pictures of the inside of the body. The ultrasound technician uses a probe (about the size of a bar of soap) pressed this against the skin to take pictures. Your child may have brief discomfort when the probe is placed on certain areas of the abdomen. The test usually takes 30 minutes to one hour to complete. Most gallstones are diagnosed with ultrasound.
• A CT scan creates detailed pictures inside the body. The scanner is a donut-shaped machine with a moveable table that slides in and out. Your child lies on the table as it moves through the scanner. CT scans only take 10 to 15 minutes. Small children can be swaddled or distracted in order to keep still.
• MRCP is a type of MRI that takes images of the liver, gallbladder, bile ducts, pancreas and pancreatic ducts. The MRI scanner is a tunnel similar to a CT scanner but it uses a powerful magnet to create images. MRI scanners can be loud, so some small children may need sedation or anesthesia.
• ERCP is a procedure done by gastroenterologists to examine the pancreatic and bile ducts. An endoscope (small, bendable light tube) is placed into the mouth, through the stomach, and into the end of the bile duct where it drains into the small intestine. Dye is injected through the ampulla to help create more detailed X-ray images. ERCP is performed in the operating room under anesthesia.
• DISIDA (hepatobiliary) scan uses a special solution injected into the veins that can be detected by special cameras as it is excreted in the bile.

How are gallstones treated?

If gallstones are causing pain and other symptoms, your child’s doctor will probably recommend removing the gallbladder. Most of the time, this is done in a minimally invasive surgery called a laparoscopic cholecystectomy. Children are under general anesthesia for gallbladder removal and usually go home the next day.

Children with severe gallstone symptoms may spend a few days in the hospital before surgery. We treat them with pain medication and IV fluids to get them ready for the operation.

Why choose us to treat gallstones?

At Children’s Hospital Colorado, we diagnose and treat many patients with cholelithiasis every year. Our Pediatric Gastroenterology & GI Surgery was recently ranked #1 in the nation by US News & World Report for our expertise and results. We pride ourselves on quicker recovery times, less pain and fewer missed days of school. Our whole team — from ultrasound technicians, to nurses, to surgeons and anesthesiologists — is dedicated to bringing the very best care to the children we care for.

Helpful resources

Learn more about the faculty and programs involved in gastroenterology and pediatric surgery.

GI Kids provides children and families with resources and easy-to-understand information on the diagnosis and management of pediatric digestive disorders, including conditions that can lead to gallstones.