Biliary and Pancreatic Stones

Biliary and pancreatic stones, also known collectively as gallstones, are small, pebble-like objects formed from hardened fluids from the pancreas or the gallbladder. These stones can get lodged in the ducts that go from those organs to the small intestine.

What are biliary stones?

Bile, a fluid made by the liver to help digest foods, is composed of water, cholesterol, fats, salts, proteins, and a yellow pigment called bilirubin. Between meals, it is stored in the gallbladder, where the solid parts of it can sometimes crystallize into the hardened objects known as gallstones. Many gallstones remain in the gallbladder, where they may not cause any harm. But when a gallstone moves into the bile duct and gets stuck there, it is called a biliary stone, and it can cause infection and other serious problems. Some children are predisposed to get biliary stones and may have several bouts over their lifetime; others may have only a single stone.

What are the symptoms of biliary stones?

The most common symptom of a biliary stone is pain in the upper-right abdominal area, where the liver and gallbladder are located.

The pain may be intermittent or continuous. If the stone is blocking a bile duct, it can cause an infection called cholangitis; bacterial infection in the liver called ascending cholangitis; or inflammation of the gallbladder, called cholecystitis. Other symptoms may include nausea, fever, chills, jaundice, dark urine, tiredness, weight loss, and light-colored stools.

What are pancreatic stones?

Like biliary stones, pancreatic stones are made of hardened digestive juices. Instead of the solids in bile, though, pancreatic stones are typically made of pieces of calcium carbonate that have hardened out of pancreatic enzymes and then get stuck in the duct leading from the pancreas to the small intestine. Some children have a genetic predisposition to get pancreatic stones and may experience several over their lifetime; others may have only a single stone.

What are the symptoms of pancreatic stones?

Pancreatic stones that block the pancreatic duct can cause pancreatitis. Symptoms of pancreatitis include nausea, vomiting, and intense abdominal pain, which can come on suddenly and can then be constant or intermittent.

How are biliary and pancreatic stones treated?

Both kinds of gallstones can usually be reached and removed in children using advanced endoscopic techniques, including ERCP.