While problems associated with the gallbladder are rare in children, almost 50 per cent of children have gallstones. Many of them--between 80 per cent and 90 per cent--have no symptoms. It isn't unheard of for stones to exist for 10 years or more without showing any outward signs, especially if they are small. However, even small stones in small children can cause problems. Approximately 40 per cent of cases occur in children younger than 11.
The symptoms for gallstones in children mimic those of other gastrointestinal problems, except for pain in a specific location. Some easily mistaken symptoms are fullness or gas, chills and shaking, fever, nausea, vomiting and heartburn. With gallstones, however, there will be a severe pain located on the right side of the child's upper-middle abdomen. The pain often will worsen during or immediately after meals or while taking deep breaths, and it may sometimes seem to move to the right shoulder blade.
Bile Duct Obstruction
If the gallstones are small enough, they may move from the child's gallbladder and block the duct leading from the liver to the small intestine. It also may block the duct leading to the pancreas. In either case, treatment is needed. The symptoms will be similar to the signs of gallstones; however, the child also will show signs of jaundice (yellowing of the skin and the whites of his eyes) and will pass clay-coloured stools.
Cholesterolosis is a disease of the gallbladder caused by deposits of cholesterol in the submucosal macrophages within the child's gallbladder. It is most commonly found in adults, but it is increasingly appearing in adolescents. It occurs in girls during puberty, potentially caused by increased oestrogen levels, and in children who have a family history of cholecystitis (an inflammation of the gallbladder wall). Symptoms are similar to gallstones, including the location and severity of pain along with vomiting and an intolerance to fatty foods.
If you suspect your child has a gallbladder problem, the paediatrician will need to run several tests. These include abdominal X-rays, CAT scans and ultrasounds. Sometimes small (under 3mm) gallstones will not show up on these tests. In that case, blood tests will be taken to determine if there is an elevated white blood cell count.
Treatment and Prevention
Gallstones in adults can be caused by different factors, but in children, heredity is most often cited as a cause. If the gallstones do not often bother the child, no treatment is needed. If the child has repeated attacks, however, then the paediatrician may recommend removing the gallbladder.