Gallstones in children whit sickle cell disease are the result of elevated bilirubin excretion due to the increased hemolysis. Gallstones are found in about 30 to 50 percent of children with sickle cell anemia. They may be symptomatic or asymptomatic. Most physicians monitor the child with asyniptomatic gallstones and do not recommend a cholecystectomy (removal of the gallbladder) until symptoms occur, Elective cholecystectomy may be indicated when gallstones are symptomatic (chronic right upper quadrant pain, nausea, vomiting, and fullness after meals).

The complications of gallstones can include passage of stones causing colic, common bile duct obstruction, cholecystitis, and rarely, pancreatitis.

Often the eyes of children with sickle cell anemia may appear yellow or jaundiced. This is due to the accumulation of a waste product (called bilirubin) from the increased RBC hemolysis associated with sickle cell disease. It is a benign complication.