Retroperitoneal fibrosis (RP) is an inflammatory tissue reaction
characterized with fibrosis in the the retroperitoneum.There
are different diagnostic radiologic studies used for the diagnosis
of RP. The disease is also called ‘Ormond disease.
In this study, we aimed to present the patient that was admitted
to our clinic with bilateral hidronephrosis and diagnosed
as retroperitoneal fibrosis, the surgical treatment of disease
and persistent clinical situation.
54 year-old male patient admitted to emergency service with
bilateral flank pain, nausea and vomiting. According to ultrasonography
there was bilateral hydronephrosis. Creatine
level increased and the patient was consulted to our clinic.
Creatinine level was 6.2mg/dl and there was oliguria. Ultrasonography
revealed right pelvicalyceal grade 3 hydronephrosis,
and left pelvicalyceal grade 1 hydronephrosis. Computerised
tomography was normal. Magnetic resonance revealed hypointense
soft tissue formation compatible with retroperitoneal
fibrosis that was in midline of abdomen and started form
truncus choliacus and extended to iliac bifurcation level and
through paraaortic and left pararenal space. Bilateral double
J catheterization and steroid treatment was given.
In early postoperative period, creatinine level decreased to
2.1 mg/dl. In the following period, bilateral uretherolysis operation
was performedin another clinic due to the increased
creatinin levels and persistent bilateral hydronephrosis according
to ultrasonography. On postoperative 6th month, patient
admitted to our clinic again with bilateral flank pain and
ultrasonography revealed right grade 3 hydronephrosis and
left grade 1 hydronephrosis. After that we performed bilateral
uretheral double J catheterization. But due to the persistent
right hydronephrosis nephrostomy catheter was inserted On
postoperative 3rd month Escherichia Coli was detected in
urine culture and appropriate antibiotherapy was given. After
treatment rightnephrostomy and left DJ catheter was removed
and right metalic DJ catheterization was performed.
On postoperative 3rd month creatinine level was 1.4 mg/dl.
There wasn’t any urinary tract infection periodic dj catheter
exchange operations planned for the patient.
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