Surgical Exploration as the Definitive Means of Diagnosing a Unilateral Idiopathic Retroperitoneal Fibrosis: Report of a Case

Abstract

Background: Retroperitoneal fibrosis is considered as one of the rare diseases, with an incidence rate of 1/200,000. A guideline for its diagnosis and therapy does not exist. In the past centuries, case studies and small-scale series have therefore been used for diagnostic purposes. Case Report: We report the case of a 45-year-old female patient who approached the emergency department complaining of flank pain. The primary diagnostics including computed tomography, magnetic resonance imaging, sonography, and laboratory testing showed a distension of the Musculus psoas and Musculus iliacus on the right side with an unclear genesis. Accessorily performed diagnostic analysis including scintigraphy and intestinal endoscopy did not provide additional information. Because of persisting complaints, a surgical exploration of the right retroperitoneal space was performed resulting in a histological diagnosis of an idiopathic fibrosis (Morbus Ormond). Conclusion: Despite the permanent improvement of diagnostic imaging in general, a surgical exploration accompanied by histological investigation is the diagnostic tool of choice in selected cases.