Retroperitoneal Fibrosis Presented with Bilateral Obstructive Uropathy: A Case Report with Literature Review

腹膜後腔纖維化併發雙側阻塞性泌尿道病變：個案報告與文獻回顧

林瑞祥(Jui-Hsiang Lin)；王偉傑(Wei-Jie Wang)；鄭美華(Mei-Hua Cheng)；羅世慧(Su-Huey Lo)

Retroperitoneal fibrosis ； Obstructive uropathy ； Hematuria ； Double-J ureteric stent ； Azathioprine ； 腹膜後腔纖維化 ； 阻塞性泌尿道病變 ； 血尿 ； 雙J型輸尿管導管 ； 硫唑嘌呤

醫學與健康期刊

7卷2期（2018 / 09 / 01）

117 - 122

英文

Idiopathic retroperitoneal fibrosis is characterized by excessive fibrotic growth throughout the retroperitoneum. Bilateral obstructive uropathy often suggests possible bladder lesion or external compression of bilateral ureters. A 72-year-old man presented a 15-day history of hematuria and abdominal pain. A CT scan of the abdomen revealed a retroperitoneal mass on the planes of the abdominal aorta, bilateral iliac arteries, and bilateral distal ureters with bilateral hydroureteronephrosis. The patient was successfully treated by implantation of bilateral double-J ureteric stents kept in place for two weeks and use of prednisone and azathioprine. No recurrence of hematuria was observed at one year follow-up. Because standard management of this disease has not been established, further investigation is needed to determine optimal treatment, frequency of imaging to assess disease activity, risk factors of relapse to management, and long-term outcomes.

腹膜後纖維化的表現是整個腹膜後纖維組織增生過多，特別是如果併發雙側阻塞性尿路病變，通常意味著膀胱病變或外部壓迫膀胱導致雙側輸尿管阻塞。72歲男性患者因15天的血尿與腹痛就診，電腦斷層掃描顯示腹膜後腫塊覆蓋住血管與腎臟併輸尿管積水，病理切片顯示其腫塊為纖維脂肪組織。我們置放雙側雙J型輸尿管導管與使用類固醇與硫唑嘌呤成功治療這位患者，經過一年的追蹤並沒有血尿復發的情況。目前對於腹膜後纖維化尚無標準治療，因此需要更多研究對於標準治療方式、影像工具追蹤時程、治療失敗危險因子與長期預後等提出相關證據。

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