1/35. retroperitoneal fibrosis with duodenal stenosis.retroperitoneal fibrosis is a rare disease characterized by the formation of dense plaque of fibrous tissue covering the retroperitoneal structures. This disease is commonly presented as ureteral obstruction, but the involvement of duodenum is rare. We report a case of retroperitoneal fibrosis which was complicated with duodenal stenosis and was successfully treated with corticosteroids. A 58-yr-old man, who had history of aorto-iliac bypass graft due to arteriosclerosis obliterans with infrarenal aortic occlusion was admitted to the hospital with abdominal pain and a mass. Abdominal CT scan revealed the periaortic soft tissue mass encircling grafted aorta and stenosis of duodenal third portion. retroperitoneal fibrosis with duodenal stenosis was diagnosed and prednisolone therapy was initiated. Follow-up CT scan showed that the patient responded to prednisolone therapy with eased pain, shrinking periaortic mass, and reduced duodenal stenosis.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
2/35. retroperitoneal fibrosis: unusual cause of low back pain.retroperitoneal fibrosis (RPF) is an uncommon collagen vascular disease with a male predominance. Back pain with no specific radiation pattern is common, and bilateral obstructive uropathy, potentially reversible, is frequently associated with RPF. We report a case of RPF and review its diagnosis and management.- - - - - - - - - - ranking = 22.432017722167keywords = back pain, back (Clic here for more details about this article) |
3/35. Pseudotumor of the pancreatic head associated with idiopathic retroperitoneal fibrosis.A 68-year-old male presented with abdominal pain and obstructive jaundice. CT revealed a large mass in the pancreatic head that was initially interpreted as pancreatic carcinoma. Needle biopsy revealed only fibrous tissue with signs of chronic inflammation. Together with typical findings of an idiopathic retroperitoneal fibrosis, the final diagnosis of multifocal idiopathic fibrosclerosis with focal pseudotumorous pancreatic head fibrosis could be made.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
4/35. Riedel's thyroiditis and retroperitoneal fibrosis in multifocal fibrosclerosis: positron emission tomographic findings.PURPOSE: The authors describe F-18 fluorodeoxyglucose positron emission tomographic (FDG PET) imaging features of Riedel's thyroiditis and retroperitoneal fibrosis in a patient with multifocal fibrosclerosis. MATERIALS AND methods: A 41-year-old woman in whom Riedel's thyroiditis had been diagnosed 7 months earlier was examined for fatigue, anorexia, and lower back pain, irradiating to the abdomen. Abdominal sonography and computed tomography showed a retroperitoneal mass. A biopsy of this mass showed histopathologic findings of retroperitoneal fibrosis. FDG PET was performed to evaluate the activity of the retroperitoneal fibrosis and to screen for other areas of fibrosclerosis. RESULTS: The FDG-PET images showed an intense hypermetabolic abdominal mass surrounding the aorta and increased glucose metabolism in the thyroid. No other sites of abnormal FDG metabolism were noted. These abnormalities disappeared after 4 months of steroid therapy. CONCLUSIONS: Sites of multifocal fibrosclerosis can be demonstrated by FDG PET, probably as a result of active inflammation involving lymphocytes, plasma cells, and fibroblast proliferation. FDG PET can help to establish the diagnosis of multifocal fibrosclerosis and evaluate the activity and patient response to corticosteroid therapy.- - - - - - - - - - ranking = 5.6080044305417keywords = back pain, back (Clic here for more details about this article) |
5/35. Azygous vein to right atrium bypass graft in a patient with idiopathic fibrosing mediastinitis and symptomatic superior and inferior vena cava obstructions.We report an unusual case of a patient with diminished cardiac output caused by systemic venous occlusions of unclear etiology with a history of idiopathic fibrosing mediastinitis and retroperitoneal fibrosis. On thoracic, abdominal, and pelvic venograms, the patient was previously known to have superior vena caval and infrarenal inferior vena caval occlusions. Subsequent studies revealed retrograde flow through the azygous and hemiazygous veins and numerous caval-portal anastomoses providing venous return from the upper and lower extremities. After an extensive hypercoagulable state work-up, no abnormalities were found. To relieve the symptoms, the patient underwent an elective right thoracotomy with azygous vein to right atrial bypass graft. The patient has had complete amelioration of the disabling symptoms and participates in many activities that he could not tolerate previously. Because this condition and procedure are unreported, we present a novel surgical treatment option to palliate symptoms caused by concurrent superior and inferior caval obstructions by improving venous return to the heart.- - - - - - - - - - ranking = 0.0079497996366235keywords = upper (Clic here for more details about this article) |
6/35. Idiopathic retroperitoneal fibrosis and ankylosing spondylitis. A new case report.The case of a 52-year-old man with retroperitoneal fibrosis and ankylosing spondylitis is described. Inflammatory low back pain and acute renal insufficiency prompted a computed tomography scan of the abdomen with contrast agent injection. A fibrous sheath surrounding the aorta and attracting the ureters toward the midline was seen, strongly suggesting retroperitoneal fibrosis. The diagnosis of ankylosing spondylitis was based on the presence of inflammatory low back pain responsive to nonsteroidal anti-inflammatory drugs, syndesmophytes at the lumbar and cervical spine, bilateral sacroiliitis, and presence of the hla-b27 antigen. prednisone therapy in a daily dosage of 1 mg/kg induced a marked improvement. Only nine cases of concomitant retroperitoneal fibrosis and ankylosing spondylitis have been reported. These two conditions share similarities in some of the etiologic factors and anatomic localizations, suggesting that both may stem from a predisposition to fibrotic diseases.- - - - - - - - - - ranking = 11.216008861083keywords = back pain, back (Clic here for more details about this article) |
7/35. Retroperitoneal fat necrosis producing ureteral obstruction.We present 3 cases of a rare syndrome of extrinsic ureteral obstruction produced by retroperitoneal fat necrosis and compare the medical records and histopathology to 19 cases of classic idiopathic retroperitoneal fibrosis. Clinical similarities include average age of onset in the fourth and fifth decades, male preponderance, abdominal or back pain as the presenting symptom, elevation of the blood urea concentration prior to diagnosis and tendency toward bilateral involvement. Histologically, the 2 conditions were different. Retroperitoneal fat necrosis is characterized by coalescence of fat cells into fat cysts bordered by foreign body giant cell granulomas, foam cells, light chronic inflammatory infiltrate and unimpressive fibrosis. The microscopic pathology of idiopathic retroperitoneal fibrosis is dominated by densely collagenized fibrous tissue of varying cellularity without evidence of fat necrosis. Of the 3 cases of retroperitoneal fat necrosis 2 featured prior ischiorectal abscesses and this is considered in a discussion of the etiology of this unusual cause of ureteral compression.- - - - - - - - - - ranking = 5.6080044305417keywords = back pain, back (Clic here for more details about this article) |
8/35. retroperitoneal fibrosis secondary to actinomycosis with no intrauterine device.BACKGROUND: Actinomycotic pelvic infection usually occurs in the presence of an intrauterine device. It can result in pelvic inflammatory disease, tubo-ovarian abscess, and retroperitoneal fibrosis. CASE: A 35-year-old multipara who had never used an intrauterine device presented with a 5-month history of progressively worsening, colicky, right-sided abdominal pain, dysuria, weight loss, and constipation. She was found to have retroperitoneal fibrosis. The diagnosis of actinomycotic pelvic infection was made at laparotomy. CONCLUSION: actinomycosis may be considered in the differential diagnosis of women with retroperitoneal fibrosis, even when there is no history of an intrauterine device.- - - - - - - - - - ranking = 1keywords = abdominal pain (Clic here for more details about this article) |
9/35. A case of retroperitoneal and mediastinal fibrosis exhibiting elevated levels of IgG4 in the absence of sclerosing pancreatitis (autoimmune pancreatitis).There is now increasing evidence that IgG4 is closely involved in idiopathic sclerosing lesions, such as sclerosing pancreatitis and sclerosing sialadenitis. In this report, we describe a case of IgG4-related retroperitoneal and mediastinal fibroses. A 52-year-old man presented with dull back pain and was found to have a continuously surrounding paraaortic mass. A biopsy specimen taken from the retroperitoneum showed a diffuse lymphoplasmacytic infiltration intermixed with fibrosis. Many IgG4-positive plasma cells were demonstrated on immunostaining. His serum IgG4 concentration was 392 mg/dL (reference range, <70). We treated this patient with a corticosteroid, which markedly diminished the paraaortic mass along with lowering of his serum IgG4 concentration. The possible involvement of IgG4 was suggested in the pathogeneses of retroperitoneal and mediastinal fibroses in this patient. IgG4 might be useful in the clinical management of retroperitoneal or mediastinal fibrosis to differentiate them from malignant tumors and predict steroid sensitivity.- - - - - - - - - - ranking = 5.6080044305417keywords = back pain, back (Clic here for more details about this article) |
10/35. Multifocal idiopathic fibrosclerosis: treatment of 2 cases with cyclosporine.We describe 2 cases of multifocal idiopathic fibrosclerosis treated successfully with cyclosporine. The first patient presented with chronic abdominal pain and was subsequently found to have retroperitoneal fibrosis with ureteral obstruction. Other findings included cholangiolar fibrosis, retroorbital pseudotumors, submandibular gland enlargement, subcutaneous fibrotic masses, and elevated erythrocyte sedimentation rate (ESR) and serum creatinine. He initially responded well to temporary ureteral stenting followed by combination therapy with steroids and cyclosporine. He relapsed when cyclosporine was stopped, but subsequently remitted completely when cyclosporine was reintroduced. The second patient presented with long-standing abdominal pain with retroperitoneal fibrosis, submandibular gland enlargement, and an enlarged pancreas with a localized mass, all of which improved significantly with 6 months of therapy with cyclosporine. cyclosporine was well tolerated with no significant side effects in the 2 patients. A review of the literature is presented.- - - - - - - - - - ranking = 2keywords = abdominal pain (Clic here for more details about this article) |
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