IDIOPATHIC RETROPERITONEAL FIBROSIS

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.