Idiopathic retroperitoneal fibrosis.

Herein is described a case report of urinary tract obstruction due to idiopathic retroperitoneal fibrosis (IRF) in a 43-year-old man. Recent studies suggest that IRF fits into the broader pathologic heading of chronic periaortitis. Although there may be more than one pathophysiologic mechanism, growing evidence suggests that many cases of IRF are due to an autoallergic reaction to lipid material in the atheromatous aorta. Computed tomographic scanning has supplanted excretory and retrograde urography in the diagnosis of this condition. Ureterolysis and steroids remain the mainstays in the treatment of IRF. Even after successful decompression of urinary obstruction, long-term follow-up is required in these patients because of the possibility of other complications such as vena caval or duodenal obstruction.