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Laparoscopic-assisted percutaneous nephrolithotomy for nephrolithiasis in a pancake kidney.

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Title: Laparoscopic-assisted percutaneous nephrolithotomy for nephrolithiasis in a pancake kidney.
Authors: Japhina HC; Internal Medicine, AIIMS Raebareli, Raebareli, Uttar Pradesh, India., Mishra A; Urology, AIIMS Raebareli, Raebareli, Uttar Pradesh, India amit.mishra.uro@gmail.com., Sarswat A; General Surgery, AIIMS Raebareli, Raebareli, Uttar Pradesh, India., Roy S; Nephrology, AIIMS Raebareli, Raebareli, Uttar Pradesh, India.
Source: BMJ case reports [BMJ Case Rep] 2026 Aug 24; Vol. 19 (8). Date of Electronic Publication: 2026 Aug 24.
Publication Type: Journal Article; Case Reports
Language: English
Journal Info: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BMJ Pub. Group
MeSH Terms: Laparoscopy*/methods , Nephrolithotomy, Percutaneous*/methods , Nephrolithiasis*/surgery , Nephrolithiasis*/diagnostic imaging , Kidney*/abnormalities , Kidney*/surgery , Kidney*/diagnostic imaging , Kidney Calculi*/surgery , Kidney Calculi*/diagnostic imaging, Hydronephrosis/etiology ; Hydronephrosis/surgery ; Humans ; Male ; Adult ; Treatment Outcome
Abstract: Pancake kidney is an extremely rare renal fusion anomaly characterised by a single discoid parenchymal mass situated within the pelvic cavity. Due to its anomalous rotation and location, it is highly susceptible to urinary stasis, resulting in nephrolithiasis and infections. This report describes the clinical course and management of a man in his 20s who presented with chronic episodic lower abdominal pain and intermittent gross haematuria. Diagnostic imaging revealed a 2.5×2.2 cm obstructive calculus in the renal pelvis of a pancake kidney, causing significant hydronephrosis. Due to the unusual location in the abdominal pelvis, which predisposes to a high risk of bowel injury, the patient underwent a successful laparoscopic-assisted percutaneous nephrolithotomy. This approach allowed for safe bowel mobilisation and direct visualisation during renal access, resulting in a stone-free status without postoperative complications. The case highlights the necessity of tailored surgical strategies when addressing nephrolithiasis in the context of rare anatomical anomalies, emphasising the role of combined minimally invasive techniques in optimising patient outcomes and minimising surgical morbidity.
(© BMJ Publishing Group Limited 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.)
Competing Interests: Competing interests: None declared.
Contributed Indexing: Keywords: Hematuria; Renal intervention; Surgical Procedure, Operative; Urological surgery; Urology
Entry Date(s): Date Created: 20260824 Date Completed: 20260824 Latest Revision: 20260914
Update Code: 20260914
DOI: 10.1136/bcr-2026-275986
PMID: 42637506
Database: MEDLINE
FullText Text:
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  Data: Laparoscopic-assisted percutaneous nephrolithotomy for nephrolithiasis in a pancake kidney.
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  Data: <searchLink fieldCode="AU" term="%22Japhina+HC%22">Japhina HC</searchLink>; Internal Medicine, AIIMS Raebareli, Raebareli, Uttar Pradesh, India.<br /><searchLink fieldCode="AU" term="%22Mishra+A%22">Mishra A</searchLink>; Urology, AIIMS Raebareli, Raebareli, Uttar Pradesh, India amit.mishra.uro@gmail.com.<br /><searchLink fieldCode="AU" term="%22Sarswat+A%22">Sarswat A</searchLink>; General Surgery, AIIMS Raebareli, Raebareli, Uttar Pradesh, India.<br /><searchLink fieldCode="AU" term="%22Roy+S%22">Roy S</searchLink>; Nephrology, AIIMS Raebareli, Raebareli, Uttar Pradesh, India.
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  Data: <searchLink fieldCode="JN" term="%22101526291%22">BMJ case reports</searchLink> [BMJ Case Rep] 2026 Aug 24; Vol. 19 (8). <i>Date of Electronic Publication: </i>2026 Aug 24.
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  Data: Journal Article; Case Reports
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22BMJ+Pub%2E+Group%22">BMJ Pub. Group </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>101526291 <i>Publication Model: </i>Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1757-790X (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%221757790X%22">1757790X </searchLink><i>NLM ISO Abbreviation: </i>BMJ Case Rep <i>Subsets: </i>MEDLINE
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  Data: <i>Original Publication</i>: London : BMJ Pub. Group
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  Data: <searchLink fieldCode="MM" term="%22Laparoscopy%22">Laparoscopy*</searchLink>/<searchLink fieldCode="MM" term="%22Laparoscopy+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Nephrolithotomy%2C+Percutaneous%22">Nephrolithotomy, Percutaneous*</searchLink>/<searchLink fieldCode="MM" term="%22Nephrolithotomy%2C+Percutaneous+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Nephrolithiasis%22">Nephrolithiasis*</searchLink>/<searchLink fieldCode="MM" term="%22Nephrolithiasis+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Nephrolithiasis%22">Nephrolithiasis*</searchLink>/<searchLink fieldCode="MM" term="%22Nephrolithiasis+diagnostic+imaging%22">diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Kidney%22">Kidney*</searchLink>/<searchLink fieldCode="MM" term="%22Kidney+abnormalities%22">abnormalities</searchLink> <br /><searchLink fieldCode="MM" term="%22Kidney%22">Kidney*</searchLink>/<searchLink fieldCode="MM" term="%22Kidney+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Kidney%22">Kidney*</searchLink>/<searchLink fieldCode="MM" term="%22Kidney+diagnostic+imaging%22">diagnostic imaging</searchLink> <br /><searchLink fieldCode="MM" term="%22Kidney+Calculi%22">Kidney Calculi*</searchLink>/<searchLink fieldCode="MM" term="%22Kidney+Calculi+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Kidney+Calculi%22">Kidney Calculi*</searchLink>/<searchLink fieldCode="MM" term="%22Kidney+Calculi+diagnostic+imaging%22">diagnostic imaging</searchLink><br /><searchLink fieldCode="MH" term="%22Hydronephrosis%22">Hydronephrosis</searchLink>/<searchLink fieldCode="MH" term="%22Hydronephrosis+etiology%22">etiology</searchLink> ; <searchLink fieldCode="MH" term="%22Hydronephrosis%22">Hydronephrosis</searchLink>/<searchLink fieldCode="MH" term="%22Hydronephrosis+surgery%22">surgery</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Treatment+Outcome%22">Treatment Outcome</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Pancake kidney is an extremely rare renal fusion anomaly characterised by a single discoid parenchymal mass situated within the pelvic cavity. Due to its anomalous rotation and location, it is highly susceptible to urinary stasis, resulting in nephrolithiasis and infections. This report describes the clinical course and management of a man in his 20s who presented with chronic episodic lower abdominal pain and intermittent gross haematuria. Diagnostic imaging revealed a 2.5×2.2 cm obstructive calculus in the renal pelvis of a pancake kidney, causing significant hydronephrosis. Due to the unusual location in the abdominal pelvis, which predisposes to a high risk of bowel injury, the patient underwent a successful laparoscopic-assisted percutaneous nephrolithotomy. This approach allowed for safe bowel mobilisation and direct visualisation during renal access, resulting in a stone-free status without postoperative complications. The case highlights the necessity of tailored surgical strategies when addressing nephrolithiasis in the context of rare anatomical anomalies, emphasising the role of combined minimally invasive techniques in optimising patient outcomes and minimising surgical morbidity.<br /> (© BMJ Publishing Group Limited 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Competing interests: None declared.
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: <i>Keywords: </i>Hematuria; Renal intervention; Surgical Procedure, Operative; Urological surgery; Urology
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  Data: <i>Date Created: </i>20260824 <i>Date Completed: </i>20260824 <i>Latest Revision: </i>20260914
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  Data: 20260914
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  Data: 10.1136/bcr-2026-275986
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  Data: 42637506
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42637506
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1136/bcr-2026-275986
    Languages:
      – Code: eng
        Text: English
    Subjects:
      – SubjectFull: Hydronephrosis etiology
        Type: general
      – SubjectFull: Hydronephrosis surgery
        Type: general
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Adult
        Type: general
      – SubjectFull: Treatment Outcome
        Type: general
      – SubjectFull: Laparoscopy methods
        Type: general
      – SubjectFull: Nephrolithotomy, Percutaneous methods
        Type: general
      – SubjectFull: Nephrolithiasis surgery
        Type: general
      – SubjectFull: Nephrolithiasis diagnostic imaging
        Type: general
      – SubjectFull: Kidney abnormalities
        Type: general
      – SubjectFull: Kidney surgery
        Type: general
      – SubjectFull: Kidney diagnostic imaging
        Type: general
      – SubjectFull: Kidney Calculi surgery
        Type: general
      – SubjectFull: Kidney Calculi diagnostic imaging
        Type: general
    Titles:
      – TitleFull: Laparoscopic-assisted percutaneous nephrolithotomy for nephrolithiasis in a pancake kidney.
        Type: main
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            NameFull: Japhina HC
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            NameFull: Mishra A
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            NameFull: Sarswat A
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            – D: 24
              M: 08
              Text: 2026 Aug 24
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              Y: 2026
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              Value: 8
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            – TitleFull: BMJ case reports
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