Idiopathic retroperitoneal fibrosis: a case of unilateral lesion

Abstract

24歳女, 側腹部痛を主訴として受診。IVPにて右水腎症を認めた。DIPにてL5付近において尿管が内方に偏位し, その遠位において狭窄を認めた。逆行性腎盂造影では仙腸関節付近に尿管の狭窄を認めた。CT, MRIでは明らかな腫瘤を認めなかった。特発性後腹膜線維症を疑い試験開腹を行った。病理組織学的に後腹膜線維症であった。尿管剥離術および腹腔内留置術を施行した。6ヵ月後, 水腎症は著明に改善し現在のところ再発の兆候を認めない

Here we report a case of idiopathic retroperitoneal fibrosis, a unilateral case, which resulted in remission by ureterolysis with intraperitonealization. A 24-year-old female was hospitalized because of hydronephrosis. Many examinations were performed with the suspicion of malignant disease, but no apparent cause was detected. We suspected idiopathic retroperitoneal fibrosis and performed surgical exploration. The pathological diagnosis was retroperitoneal fibrosis. Ureterolysis with intraperitonealization of the ureter was performed. Six months later, marked improvement of the right hydronephrosis was observed without steroid therapy.