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2025, Number 4

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Cir Gen 2025; 47 (4)

Bilateral obstructive uropathy associated with Ormond's disease

Sánchez RVW, Reyes AO, Landaverde SJP, Damacio BRE

Language: Spanish
References: 14
Page: 271-275
PDF size: 629.84 Kb.


ABSTRACT

Retroperitoneal fibrosis is a rare disease characterized by the proliferation of inflammatory and fibrous tissue in the retroperitoneum. It is usually located around the infrarenal abdominal aorta and iliac arteries, affecting the ureters or other retroperitoneal organs. In 70% of cases, the disease is idiopathic and may be related to immunoglobulin G4. Below is the clinical case of a 48-year-old man with a history of diabetes, who began in 2021 with abdominal pain in the right upper quadrant radiating to the lumbar region, nausea and vomiting. Idiopathic retroperitoneal fibrosis was diagnosed after imaging and biopsy studies revealed interstitial fibrosis and chronic panniculitis. A right nephrostomy and placement of a left double J catheter was performed due to bilateral ureteral obstruction along with immunosuppression, presenting partial improvement. Therefore, it was decided to perform bilateral ureterolysis and peritonization. The patient progresses favorably in the postoperative period. The use of ureteral stents may be successful in relieving urinary obstruction; however, these stents are only for temporary use. For this reason, surgical ureterolysis remains the cornerstone of treatment. This case highlights the clinical interest in retroperitoneal fibrosis, often managed by surgeons, urologists, vascular surgeons, nephrologists and rheumatologists, emphasizing the importance of multidisciplinary analysis in unusual conditions.


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