Publications by authors named "Hamad Alakrash"

3 Publications

  • Page 1 of 1

Giant hydronephrosis management in the Era of minimally invasive surgery: A case series.

Int J Surg Case Rep 2020 23;75:513-516. Epub 2020 Sep 23.

Prince Sultan Military Medical City, Urology Department, Riyadh, Saudi Arabia. Electronic address:

Introduction: Giant hydronephrosis (GH) is a rare urological entity, described as more than 1 L of fluid contained in the renal collecting system. Ureteropelvic junction obstruction (UPJO) is the most common cause. GH if not discovered and managed early can result in long term complications. We present our experience in the late presentation of adult Giant hydornephrosis.

Presentation Of Cases: We reviewed all the cases of patients with giant hydronephrosis who presented to our institute from December 2017-December 2019 at our institute. Pre-operative renal ultrasound, computed tomography with contrast and MAG-3 were performed on all patients to establish their diagnoses. The patients' demographic data, clinical presentation, preparatory investigations, indications for intervention, type of intervention, pre- and post-operative complications and durations of hospital stay were reported. Laparoscopic transperitoneal nephrectomy was completed in three cases without open conversion. One case proceeded to open conversion owing to a lack of space and severe adhesions. The mean operating time was 79.7 min (range: 65-95 min), estimated blood loss was 75 mL and the mean hospital stay was 4 days (range: 2-6 days).

Discussion: The first case of GH was described in 1746. Since then, few cases have been described in the literature. A radiological definition, is the occupation of the hemi-abdomen by the kidney with a midline cross which is the height of five vertebral bodies. GH may be congenital or acquired. The most common presentation of GH is abdominal distention followed by fever and flank pain.

Conclusion: When nephrectomy is indicated in giant hydronephrosis, the laparoscopic trans-peritoneal approach is feasible. Pre-operative decompression using a nephrostomy tube and suspension stitch use facilitate the surgery.
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September 2020

Does spontaneous renal hemorrhage mandate close surveillance for impending renal cell carcinoma? A case report and literature review.

Int J Surg Case Rep 2020 20;73:44-47. Epub 2020 Jun 20.

Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Electronic address:

Introduction: Renal cell carcinoma (RCC) classically presents as a triad of hematuria, loin pain, and a palpable mass. However, Renal cell carcinomas (RCCs) nowadays are more commonly present as incidental findings rather than symptomatic. Wunderlich syndrome is a rare first presentation of RCC.

Presentation Of Case: We present a clinical case of spontaneous renal hemorrhage with unclear etiology that was treated with therapeutic embolization and was found to have renal mass after long follow up.

Discussion And Conclusion: In regards to treating Wunderlich syndrome, some authors favor angioembolization and follow up. Others proposed radical nephrectomy in conditions with no apparent etiology and normal contralateral kidney because of the high incidence of small renal tumors. Spontaneous perinephric hematoma of unknown etiology should be followed up regularly with a CT image for concerning of impending renal tumor.
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June 2020

A case report of a xanthogranulomatous pyelonephritis case mimicking the recurrence of renal cell carcinoma after partial nephrectomy.

Urol Ann 2015 Oct-Dec;7(4):524-6

Department of Urology, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.

A 44-year-old female presented to the urology clinic with flank pain and tenderness. After full assessment, the patient was booked for surgery for partial nephrectomy and the patient was diagnosed with renal cell carcinoma (RCC) chromophob type. Six months later, the patient came back for follow-up; a mass was detected on the same kidney. Radical nephrectomy was performed to excise what is thought to be a recurrence of RCC and the tissues were sent to pathology. The postoperative pathology report confirmed the presence of xanthogranulomatous pyelonephritis rather than RCC recurrence.
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December 2015