Pediatric Cholelithiasis

Etiology in neonates: cholestasis, diuretics
Etiology beyond neonates: hemolysis (due to sickle cell disease, thalassemia, hereditary spherocytosis), cystic fibrosis, inflammatory bowel disease, obesity
Imaging: primarily radiolucent on AXR

Radiology Cases of Cholelithiasis

AXR and CT of cholelithiasis due to sickle cell disease — AXR AP (left) shows faint calcifications in the right upper quadrant, just beneath the tip of the 12th rib and at the level of the L2 vertebral body which are better demonstrated on the coronal CT without contrast of the abdomen which demonstrates 5 calcifications within the gallbladder.

MR of gallstone — Coronal HASTE (above) and axial T2 (below) MRI without contrast of the abdomen shows the gallbladder to contain over 20 small, round low-signal intensity objects. The gallbladder wall is not thickened.