However, many of them are asymptomatic. It is now felt that cholesterol stones are more common than pigment stones in children. Cholecystitis and cholelithiasis are more common in childhood than is generally appreciated. Other children at increased risk include premature infants on furosemide and children receiving parenteral nutrition. The usual clinical presentation of cholecystitis and cholelithiasis is often not present in children.
Most children present with non-specific abdominal pain.
Liver function studies may be normal. Plain film abdominal radiographs may reveal calcifications, however, they are often normal. Ultrasound is the easiest means of making a definitive diagnosis of cholelithiasis. Acute cholecystitis may require a bile duct flow study such as a nuclear medicine excretion study. Pediatric experience with newer therapeutic approaches such as lithotripsy and bile acid stone dissolution are lacking.