CT in retroperitoneal fibrosis.

Of 23 cases of surgically proven retroperitoneal fibrosis evaluated by computed tomography (CT), 11 were examined preoperatively, while 12 were examined by CT in a retrospective study. The fibrosis appeared as a prevertebral retroperitoneal mass or as a fibrous sheet covering the central vessels and the ureters in 15 patients. The CT appearance corresponded well with the surgical findings in these cases. CT failed to visualize the fibrosis in eight cases mainly when the fibrosis was limited to the pelvis surrounding the distal ureters. A combination of retroperitoneal fibrosis and aortic aneurysm was found in five cases. CT is considered valuable in the evaluation of patients wtih suspected retroperitoneal fibrosis. It gives direct information about the fibrosis and is usable also in uremic patients.

Abdominal aortic aneurysm in combination with retroperitoneal fibrosis.

During the 10 year period 1969-1979 145 patients with abdominal aortic aneurysm and 21 patients with retroperitoneal fibrosis were surgically treated in our department. Five patients had both disorders simultaneously. In four of them one or both ureters were involved in the fibrotic process and ureterolysis was performed in three and a nephrectomy in one. Three patients had the aneurysm resected simultaneously, two of them as an emergency operation because of threatening rupture. In this small group of patients with both disorders, signs and symptoms were the same as those patients with either retroperitoneal fibrosis or aortic aneurysm alone. The question whether retroperitoneal fibrosis in such cases primary or secondary to abdominal aortic aneurysm or they are coincidental, is still unanswered. The treatment of choice is ureterolysis and resection of the aneurysm in a one stage procedure.