Retroperitoneal Fibrosis

Retroperitoneal Fibrosis

The Common Vein Copyright 2008

Definition

Retroperitoneal fibrosis (RPF) is a fibrogenic inflammatory process of the connective tissue of the retroperitoneum that has acute, subacute and chronic manifestations.

The cause of the disease in most cases is unknown, but it seems to be commonly associated with atherosclerosis.  It has been suggested that it is an autoimmune response to a lipid that originates from the atherosclerotic process arising in the wall of the aorta.  The lipid is known as ceroid.

Other associated causes include inflammatory diseases such as post irradiation, drugs (methysergide chemotherapy) retroperitoneal infection or malignancy.

The result is progressive fibrosis of retroperitoneal connective tissue, with the dominant result being the stenosis and subsequent obstruction of the ureters.

Treatment options include surgical release.  The use of steroids is controversial.

Ureteric Stricture with Hydronephrosis

22200c01 aorta ivc vein inferior vena cava abdomen atherosclerosis atheroma ureter retroperitoneal fibrosis RPF CTscan Courtesy Ashley Davidoff MD 22204c01 22199c02 22199c03 22200 22200c01

Ureteric Stricture with Hydronephrosis

22199c02 aorta ureter ezxtrinsic constriction dx retroperitoneal fibrosis RPF hydronephrosis kidney striated nephrogram IVP calyx calyces blunting of fornices Courtesy Ashley Davidoff MD 22204c01 22199c02 22199c03 22200 22200c01

Ureteric Stricture with Hydronephrosis

22204c01 aorta ivc vein inferior vena cava abdomen atherosclerosis atheroma ureter retroperitoneal fibrosis RPF CTscan Courtesy Ashley Davidoff MD 22204c01 22199c02 22199c03 22200 22200c01

 

References

http://www.emedicine.com/radio/topic605.htm