Presentation
Flanks pain.
Patient Data
an ill-defined soft tissue density retroperitoneal masses at the level of L2/L3 up to L4/L5 encasing the distal abdominal aorta, inferior vena cava, iliac vessels and narrowing of both ureters resulting in moderate bilateral proximal hydroureteronephrosis. Delayed contrast excretion of the right kidney in the delayed excretory phase compared to the left side suggests a higher degree of obstruction
the gallbladder is distended with dependent hyperdense contents suggesting sludge/calcium milk
a small accessory spleen is seen near the splenic hilum and pancreatic tail (Normal variant)
Case Discussion
Retroperitoneal fibrosis is a condition that was previously described as chronic periaortitis. It is an uncommon fibrotic reaction in the retroperitoneum that typically presents with ureteric obstruction. Though it's male predominance, our current case is in a female.
Idiopathic retroperitoneal fibrosis is a type of retroperitoneal fibrosis where no etiology is found and usually presents with ureteric obstruction which can be unilateral or bilateral.
The current case presented with ureteric obstruction symptoms and shows classic radiological CT features of retroperitoneal fibrosis.
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