Jackstones are stones in the urinary tract that have the characteristic appearance resembling six-pointed toy jacks. They are nearly always reported to occur in the urinary bladder, and the occurrence in less capacious renal pelvis is unusual. We report a solitary, typical jackstone in the renal pelvis without significant outflow obstruction that was successfully treated with retrograde intrarenal surgery followed by extracorporeal shockwave lithotripsy. This highlights the complex pathophysiological mechanisms in stone formation which needs to be further studied. It is important to recognize the characteristic shape of the renal calculi on the radiological investigation in the diagnosis of the jackstones.
Jackstones are stones in the urinary tract that have the characteristic appearance resembling six-pointed toy jacks. They are nearly always reported to occur in the urinary bladder [
A 63-year-old woman presented with painless intermittent visible haematuria of 4 months duration with no history of flank pain, fever, or vomiting. She had type 2 diabetes mellitus for 18 years. Clinical examination was unremarkable. X-ray KUB showed a typical jackstone in the right kidney (Figure
(a) X-ray: typical jackstone in the right kidney. (b) Reconstructed image of noncontrast computerized tomography (NCCT) confirming the presence of jackstone. (c) NCCT showing the right renal jackstone with mild hydronephrosis and no proximal hydroureter. (d) Endoscopic images showing a jackstone.
Jackstone in the kidney is exceedingly rare, and our review of the literature revealed only few previous reports [
Our case is unique as the patient presented with a solitary large jackstone (
The exact pathophysiology of development of jackstone is poorly understood. Outflow obstruction remains the most common cause of bladder calculi in adults which was also seen with jackstones in the bladder [
We report a solitary, large, typical jackstone in the renal pelvis without significant outflow obstruction. This highlights the complex pathophysiological mechanisms in stone formation within the urinary system which needs to be further studied. It is important to recognize the characteristic shape of the renal calculi on the radiological investigation in the diagnosis of the jackstones.
Kidney-ureter-bladder
Noncontrast computed tomography
Diethylenetriamine pentaacetic acid
Calcium oxalate monohydrate
Calcium oxalate dihydrate.
All data generated or analysed during this study are included in this published article.
Informed written consent was obtained from the patient for publication of this manuscript, including images or other personal or clinical details of the patient.
The case report was presented as an abstract in the annual conference of the Sri Lanka Medical Association, “133rd Anniversary International Medical Congress in 2020”,
The authors declare that they have no competing interests.
SASG and UJ conceived and designed the report and collected and organized the data. UJ, MHF, SASG, and SNK wrote the initial and final draft of the article and provided logistic support. All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript. Serozsha Goonewardena and Umesh Jayaraja have equal contribution.