Cholelithiasis

Cholelithiasis is the medical term for the presence of stones in the gallbladder or the biliary tract. 

In children, gallstones are not common before the age of 10 years. 

The presence of cholelithiasis in the pediatric age group is associated with congenital hemolytic anemias. 

Gallstones are predominantly cholesterol or pigment stones. 

Pigment stones are chiefly composed of calcium salts of bilirubin with a varying proportion of fatty acids, cholesterol, calcium phosphate and calcium carbonate.

Clinically, this condition will manifest as intermittent, colicky abdominal pain of varying intensity that may localized in the epigastric area or right upper quadrant. 

The patient may also have mild to moderate jaundice. 

There is also the history of fatty food intolerance.

So as a physician, if a child with hemolytic anemia presents with colicky right upper quadrant pain and tenderness, then one should think that this could be a case of cholelithiasis. 

Laboratories like abdominal xrays, or oral cholecystography and ultrasonography can be done to confirm the diagnosis.