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Obstrüktif Nefropatiye Neden Olan ve Sürrenal Glandı Tutan İdiyopatik Retroperitoneal Fibrozis: Olgu Sunumu

Idiopathic Retroperitoneal Fibrosis Causing Obstructive Nephropathy and Involving Surrenal Gland: A Case Report

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2004

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
A 41-year old male patient was admitted to our hospital with the complaints of reduced urine, swelling and increased urea and creatinine values. Bilateral hydronephrosis was detected by ultrasonography, but the surrounding tissues couldn't be clearly examined. Ureteral catheter and then bilateral percutaneous nephrostomy were applied. The patient's complaints reduced in the follow-up period. The intravenous urogram was performed to explain the reason of hydronephrosis. The left kidney was nonfunctioned while the right kidney was functioning. An abdominal computed tomography scan showed a soft-tissue mass encasing the aorta, the left ureter and left surrenal gland and causing hydronephrosis. The appearance observed by magnetic resonance imaging scan was considered consistent with the diagnosis of retroperitoneal fibrosis. The entire body Ga-67 scintigraphy demonstrated an uptake in the same area. Steroid treatment was started to the patient. A clinical recovery was observed during the follow-up period. Regression in retroperitoneal fibrosis was confirmed by the post-therapy abdominopelvic computed tomography scan and Ga-67 scintigraphy. In addition to malignancies, retroperitoneal fibrosis should be considered in the differential diagnosis of an abdominal mass observed in case with acute renal failure secondary to obstructive nephropathy.
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Abstract (Original Language): 
Kırk bir yaşında erkek hasta, idrarda azalma, tüm vücutta şişlik, üre ve kreatinin değerlerinin yüksekliği nedeni ile kliniğimize başvurdu. Ultrasonografide bilateral hidronefroz tespit edilen ve çevre doku¬lar net değerlendirilemeyen hastaya üreteral kateter ve daha sonra bi¬lateral perkütan nefrostomi kateteri takıldı. Takiplerde yakınmaları kay¬bolan hastanın hidronefrozunun nedenini açıklamak amacı ile yapılan intravenöz pyelografi incelemesinde sol böbrek nonfonksiyone, sağ böbrek fonksiyone idi. Abdominal bilgisayarlı tomografi incelemesin¬de aorta, sol üreter ve sol sürrenal glandı saran, aynı zamanda hidro-nefrozise neden olan yumuşak doku kitlesi saptandı. Manyetik rezo¬nans incelemede saptanan bulgular retroperitoneal fibrozisle uyumlu olarak kabul edildi. Yapılan tüm vücut Ga-67 sintigrafisinde, manyetik rezonans inceleme ile saptanan bölgelerde tutulum görüldü. Hastaya steroid tedavisi başlandı. Hastada izlem süresinde klinik olarak düzelme gözlendi ve abdominopelvik bilgisayarlı tomografi ve Ga-67 incele¬mesi de gerilemeyi doğruladı. Obstrüktif nefropatiye bağlı gelişen akut böbrek yetmezliği olgularında, batında kitle tespit edildiğinde, malignensilere ek olarak retrope-ritoneal fibrozis de ayırıcı tanıda yer almalıdır
FULL TEXT (PDF): 
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  • 3
174-176
  • Turkish

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