A four year old patient with known sick'e cell-lhalasseTiic anemia (a seldom seen d sease in Chile) and frequent severe infections (including meningitis, pneumonic, acute diarrhea crd acute oMis media) came 'o t"e emergency room a couple of weeks after a" acute resp.rarorv disease, because of fever,, acu'e abdo.Ti'nal pain, signs of peritoneal 'rritation and periphe'al e leva tec white blcoc cell counts. At abdominal ul : rasonocrap n y a bigger than normal, distended and dilated gallbladder was seen A cholecystectomy was done and the diagnosis of acalculous cholecystitis was sjrgically crd histologically comfirmed while bacteriae were not isc a ted from bile cultures. Cholecystitis was though-to be probably secondary to cystic djct external compression oy an enlarged mese^teric lymph node. Appropriate managemen; of these patents incljdes intravenous fluids, blood transfjssions as needed, adecuate control of termo 1 environment, body temperature and oxigenaticn and antimicrobial drugs to protect them against the ris^s of sepsis, hemolyt'C and throrrbcric cornp icatio.ns *o which 'hey ore frequently suo'ected.(Key words' anemia, skxe cell, thalassemia, cholecysriHs. gallblader d'seases.)Las afecciones biliares son -por lo generalpoco frecuemes en los ninos, destac^ndosc entre ellas las connatales (hepatitis neonalal, atresia de vi'as biliares, quisle de coledoco) y, en adoIcscentes, la enfermedad litiasica vesicular 1 -2 . Sin embargo, en ninos que sufren anemia hemolitica se puede desarrollar litiasis vesicular sintomatica. Los pacientes de anemia falcifonne, entidad rara en esta parte del mundo, pero frecuente en personas de raza negra, suelen tcner episodios agudos de dolor abdominal que requieren la diferenciaci6n entre apendicitis aguda, colecistitis aguda, isquemia intestinal por fenomenos vasculares obstruclivos. Adernas estos ninos pueden tencr alteraciones de la inmunidad, ya que el ba/,o se encuentra en un estado de hipocsplenia debido a fenomenos tromboticos propios de la anemia falcifonne, y ser mas susccptibles a las infecciones 3 * 4 . Por su rareza en maestro medio y las dificultades que puede acarrear cl diagnostico diferencial en cstos casos, se describe un preescolar con anemia falciforme talasemica v dolor abdominal aeudo.