Retroperitoneal Fibrosis and Inapparent ObstructiveUropathy

Abstract

Emphasis is placed on the minor degree of caliectasis often observed in the presence of severe renal failure in patients with retroperitoneal fibrosis. This finding should suggest the diagnosis in individuals presenting with obscure causes of renal failure. A possible explanation for this is based upon an interference with ureteral dynamics and subsequent interference with normal ureteral peristatic activity rather than mechanical obstruction of the ureter per se. Twenty-one patients with retroperitoneal fibrosis are reported with the usual sex and age distribution (mostly male, aged 40-55 years). Two of the patients are interesting because of associated cardiac disease and 31 had been on prolonged methysergide therapy for migraine headaches. Eighteen patients appeared to be improved or cured and 3 died.

Acute Non-Dilating Obstructive Renal Failure in a Patient with AIDS

“…Similar find ings have been described before in separate reports of three patients with lymphomatous involvement of the genitourinary tract [10][11][12], in patients with retroperito neal fibrosis [ 13]. and with other disorders [ 14], In many of these patients as in our patient, the surrounding mass of abnormal tissue appears to have prevented the ex pected dilatation of urinary-tract structures proximal to the obstructing lesion. Thus, in patients with renal fail ure, the lack of classical findings of dilatation of the uri nary tract in sonographic or tomographic studies does not rule out obstruction as the cause of the renal failure.…”

Retroperitoneal fibrosis: use of CT in distinguishing among possible causes

“…Mild proximal hydronephrosis is usually present, but with disproportionately elevated creatinine levels. This may result from an interference with ureteral peristaltic activity rather than mechanical obstruction of the ureter by the fibrosis [3]. [6,7].…”

Retroperitoneal Fibrosis: Evaluation by Ultrasonography and Color Doppler Imaging

“…An im portant aspect in the follow-up of patients with retroperi toneal fibrosis is to observe whether hydronephrosis will develop or not. Obscuring of the affected area by intesti nal gas is an occasional limitation of ultrasound [12][13][14][15].…”