**1. Introduction**

Gall stones is a known entity in adults, but are considered uncommon in pediatric population with a prevalence of 0.13% to 0.2% [1] and no clear approach has been defined. However, in the recent years, mainly with wide spread use of ultrasonography, cholelithiasis in children is being frequently reported. Unlike adults the asymptomatic presentation is less likely in children (17–50%) [2, 3]. In children there is no difference in both genders pre pubertal, however there is female predominance after puberty. In some other cases, they are reported in association with clinical symptoms such as cholecystitis and cholangitis [4, 5]. Etiology of gall stones in children is not similar to adults. Many studies have shown haemolytic diseases are the most common causes of cholelithiasis in children [20–30%], followed by other cause like obesity, total parenteral nutrition, ileal disease or resection, congenital hepatobiliary diseases, use of ceftriaxone and idiopathic [6]. Other causes like metabolic syndrome, PFIC (progressive familial intrahepatic cholestasis), choledochal cyst, biliary cirrhosis, prematurity, necrotizing enterocolitis (NEC), Wilson disease, congenital heart diseases, cystic fibrosis, should also be considered.
