Herein is described a case report of urinary tract obstruction due to
idiopathic retroperitoneal fibrosis (IRF) in a 43-year-old man. Recent
studies suggest that IRF fits into the broader pathologic heading of
chronic periaortitis. Although there may be more than one pathophysiol
ogic mechanism, growing evidence suggests that many cases of IRF are d
ue to an autoallergic reaction to lipid material in the atheromatous a
orta. Computed tomographic scanning has supplanted excretory and retro
grade urography in the diagnosis of this condition. Ureterolysis and s
teroids remain the mainstays in the treatment of IRF. Even after succe
ssful decompression of urinary obstruction, long-term follow-up is req
uired in these patients because of the possibility of other complicati
ons such as vena caval or duodenal obstruction.