title: Diffuse abdominal pain, nausea and vomiting due to retroperitoneal fibrosis: a rare but often missed diagnosis.
abstract: Retroperitoneal fibrosis is a rare chronic inflammatory disease usually involving the ureters, retroperitoneal vessels and nerves; however, any intestinal organ may also be involved. In recent years, a few successful immunosuppressive treatments of this disease have been described and surgery can, therefore, probably be avoided in most cases. We report here on a case of secondary retroperitoneal fibrosis with compression and midline deviation of the ureters and impaired renal function which was probably caused by ergotamine abuse because of migraine. The patient complained of diffuse abdominal pain, nausea and vomiting. After immunosuppressive treatment with azathioprine and prednisone for a year, we observed a complete resolution of the retroperitoneal mass on computed tomography, although renal function remained impaired. Eleven months after the cessation of treatment, the patient had not relapsed.
authors.affiliation: Department of Medicine, Inselspital, University of Berne, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Netzer
authors.forename: J
authors.initials: J
authors.lastname: Binek
authors.forename: B
authors.initials: B
authors.lastname: Hammer
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014567:Urography; D014839:Vomiting / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents