DIFFUSE ABDOMINAL-PAIN, NAUSEA AND VOMITING DUE TO RETROPERITONEAL FIBROSIS - A RARE BUT OFTEN MISSED DIAGNOSIS

Retroperitoneal fibrosis is a rare chronic inflammatory disease usuall y involving the ureters, retroperitoneal vessels and nerves; however, any intestinal organ may also be involved. In recent years, a few succ essful immunosuppressive treatments of this disease have been describe d and surgery can, therefore, probably be avoided in most cases. We re port here on a case of secondary retroperitoneal fibrosis with compres sion and midline deviation of the ureters and impaired renal function which was probably caused by ergotamine abuse because of migraine. The patient complained of diffuse abdominal pain, nausea and vomiting. Af ter immunosuppressive treatment with azathioprine and prednisone for a year, we observed a complete resolution of the retroperitoneal mass o n computed tomography, although renal function remained impaired. Elev en months after the cessation of treatment, the patient had not relaps ed.