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Q. My 11 year old son has acute periumbilical abdominal pain. Is surgery necessary for gallstones?

Answered by
Dr. Faisal Abdul Karim Malim
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 20, 2017 and last reviewed on: Sep 23, 2021

Hello doctor,

My 11 year old son has acute periumbilical abdominal pain after waking up and vomited a couple of times. Before, he used to wake up with mild to moderate pain, but three days back he had severe pain. The pain got relieved half way to the ER, so we came back home. I noticed early the following week that his urine was coke colored, so I took him to our family practitioner. His urine test showed bilirubin. Lab test showed elevated amylase, lipase, and all liver enzymes. The pediatrician did a clean out with Miralax, and after one week the new labs showed all enzymes to be normal, ALT was 61. Ultrasound showed normal liver and pancreas, but gallbladder was showing echogenic foci in the gallbladder lumen, which may represent non-shadowing cholelithiasis or tumefactive sludge. GI specialist is not entirely confident if it is gallbladder stone but is setting him up for surgery. As a mother who had gallstones, this is exactly how I was. I am worried because they are not 100 % sure he passed a stone or has gallbladder problems. He has BMI of 31, and he lost 25 lbs through diet and exercise over the last six months. I am attaching his reports, and I need some mental reassurance.

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#

Hi,

Welcome to icliniq.com.

  • The symptoms and the reports (attachment removed to protect patient identity) are pointing towards cholelithiasis.
  • Also, this is more likely since you have mentioned in your history you have the same issue.
  • Depending on the type of stones, the next step is either removal of the gall bladder along with the stones, or just crushing of the stones or medical treatment.
  • However, most surgeons prefer to wait if the symptoms are not debilitating. So, based on the severity and recurrence of the symptoms a call can be taken if we have to remove the gall bladder completely.
  • Do not worry about the procedure, as it can be done laparoscopically as well.

For more information consult a paediatrician online --> https://www.icliniq.com/ask-a-doctor-online/paediatrician

Hello doctor,

Thank you for the reply. Can it be anything worse or life-threatening, since enzymes seem to be returning to normal? The doctor mentioned liver biopsy. Thanks for the reassurance, I have been crying nonstop.

#

Hi,

Welcome back to icliniq.com.

  • Do not worry, as long as the clinical condition is good, there is no cause of worry.
  • Most of these cases resolve post surgery, except for some occasional digestive and growth issues, which can be taken care by a proper diet and medicines.

For further queries consult a paediatrician online --> https://www.icliniq.com/ask-a-doctor-online/paediatrician


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