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《CHINESE JOURNAL OF INTERNAL MEDICINE》 1998-06
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Retroperitoneal fibrosis: report of 3 cases and reviews of the literature in recent thirty years

Qian Jiaming*, Wang Ruiqin, Lu Chongmei. *Department of Digestive Diseases, Peking Union Medical College Hospital, Beijing 100730  
Objective A total of 44 cases of retroperitoneal fibrosis (RPF) reported in the literature in recent 30 years were reviewed, including 3 cases from Peking Union Medical College Hospital and 41 cases from other hospitals. The purpose of this paper is to analyze the clinical manifestations, so that diagnosis may be made and treatment instituted as early as possible. Methods and Results (1) Clinical symptoms and signs: The incidence of RPF in male was slightly higher than that in female (1.4∶1). The initial symptom of RPF was quite variable, but back or flank pain, abdominal pain and oliguria with physical signs of either swollen leg or ascites were most commonly seen. (2) Diagnosis: For masses in retroperitoneal space, CT is considered as the diagnostic method of first choice, because the diagnostic rate of CT (88.9%) is much higher than that of B mode ultrasonography (20.6%). However, B mode ultrasonography (86.2%) and intravenous pyelography (69.2%) were more sensitive methods for the involvement of renal pelvis and upper ureter. For lesions in lower ureter, retrograde pyelography (84.6%) should be first considered. The ratio of idiopathic RPF and secondary RPF is about 2.1∶1. (3) Treatment: Use of cortisone was essential in longterm control. Tamoxifen has also been used recently. Conclusion The final diagnosis of RPF depends on pathology and surgery. Image examination is quite important in diagnosis and differential diagnosis. It is suggested that presence of gastrointestinal tumor should be noted in case of secondary RPF. Drug therapy is only used in the early or middle stage of RPF, while surgical therapy should be resorted to in the late stage of RPF.
【CateGory Index】: R44
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