Becker Mike
Klinik für Rheumatologie, Universitätsspital Zürich.
Ther Umsch. 2022 Jun;79(5):254-259. doi: 10.1024/0040-5930/a001357.
Chronic Periaortitis The term chronic periaortitis encompasses several fibroinflammatory diseases that manifest on or around the abdominal aorta which may be associated with aneurysm formation. Formerly distinct entities are grouped together, such as idiopathic retroperitoneal fibrosis (Ormond's disease), inflammatory aortic aneurysm, and perianeurysmal retroperitoneal fibrosis. They may also occur IgG4-related. The most common complications of these systemic inflammatory diseases are ureteric obstruction and secondary renal failure, but venous compression with congestion and thrombosis may also occur. This review focuses on the diagnosis and treatment of chronic periaortitis. The diagnosis is usually made by cross-sectional imaging, and various therapies, especially immunosuppressive agents, are used therapeutically, although good evidence is largely lacking. For bridging, a ureteric stent is often placed and in individual cases surgical therapy is also necessary. Due to the heterogeneity of the diseases and their rarity, there are hardly any standardized treatment procedures.
慢性主动脉周炎 “慢性主动脉周炎” 这一术语涵盖了几种在腹主动脉上或其周围表现出的纤维炎症性疾病,这些疾病可能与动脉瘤形成有关。以前不同的实体被归为一类,如特发性腹膜后纤维化(奥蒙德病)、炎性主动脉瘤和动脉瘤周围腹膜后纤维化。它们也可能与IgG4相关。这些全身性炎症性疾病最常见的并发症是输尿管梗阻和继发性肾衰竭,但也可能发生静脉受压伴充血和血栓形成。本综述重点关注慢性主动脉周炎的诊断和治疗。诊断通常通过横断面成像进行,并且使用了各种治疗方法,尤其是免疫抑制剂,尽管在很大程度上缺乏充分的证据。为了过渡,通常会放置输尿管支架,在个别情况下手术治疗也是必要的。由于这些疾病的异质性及其罕见性,几乎没有任何标准化的治疗程序。