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Obstructive Pathophysiologic Changes in Retroperitoneal Fibrosis

Obstructive Pathophysiologic Changes in Retroperitoneal Fibrosis Abstract THE DIAGNOSIS of idiopathic retroperitoneal fibrosis as described first in the English literature by Ormond in 1948 is being made with increasing frequency.1 As physicians become more aware of this clinical syndrome and its symptom complex, the diagnosis will also be made earlier in the course of the disease. At the present time, over 100 cases have been reported in various journals. The following case is presented not only as an example of idiopathic retroperitoneal fibrosis, but also as an illustration of the phenomenon of diuresis following the relief of urinary tract obstruction. This diuresis has occurred most commonly following relief of vesical neck obstruction.2-4 The importance of early recognition and proper management of the rapidly changing and shifting body constituents has been stressed repeatedly, for it has been truly said that the fluid and electrolyte imbalance may represent a more immediate threat to life than the underlying References 1. Ormond, J.K.: Bilateral Ureteral Obstruction Due to Envelopment and Compression by an Inflammatory Retroperitoneal Process , J Urol 59:1072, 1948. 2. Tactac, A.Y., and Thuman, R.C., Jr.: Electrolyte Balance Following Relief of Chronic Urinary Tract Obstruction , Surg Clin N Amer 39:1661, 1959. 3. Eiseman, B.; Vivion, C.; and Vivian, J.: Fluid and Electrolyte Changes Following Relief of Urinary Obstruction , J Urol 74:222. 1955. 4. Wilson, B.; Riseman, D.; and Mayer, C.: Fluid Balance in Urological Patient: Disturbances in the Renal Regulation of the Excretion of Water and Sodium Salts Following Decompression of the Urinary Bladder , J Urol 66:805, 1951. 5. Hinman, F.: Hydronephrosis: I. The Structural Changes , Surgery 17:816, 1945. 6. Hinman, F.: Hydronephrosis: II. The Functional Changes , Surgery 17:836, 1945. 7. Bricker, N., et al: An Abnormality in Renal Function Resulting From Urinary Tract Obstruction , Amer J Med 23:554, 1957.Crossref 8. Stewart, J.; Stewart, W.; and Gillie, H.: Cardiac Arrest and Acidosis , Lancet 283:964, 1962.Crossref 9. Maher, J.F.; Schreiner, G.E.; and Waters, T.J.: Osmotic Diuresis Due to Retained Urea After Release of Obstructive Uropathy , New Eng J Med 268:1099, 1963.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Obstructive Pathophysiologic Changes in Retroperitoneal Fibrosis

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320230043007
Publisher site
See Article on Publisher Site

Abstract

Abstract THE DIAGNOSIS of idiopathic retroperitoneal fibrosis as described first in the English literature by Ormond in 1948 is being made with increasing frequency.1 As physicians become more aware of this clinical syndrome and its symptom complex, the diagnosis will also be made earlier in the course of the disease. At the present time, over 100 cases have been reported in various journals. The following case is presented not only as an example of idiopathic retroperitoneal fibrosis, but also as an illustration of the phenomenon of diuresis following the relief of urinary tract obstruction. This diuresis has occurred most commonly following relief of vesical neck obstruction.2-4 The importance of early recognition and proper management of the rapidly changing and shifting body constituents has been stressed repeatedly, for it has been truly said that the fluid and electrolyte imbalance may represent a more immediate threat to life than the underlying References 1. Ormond, J.K.: Bilateral Ureteral Obstruction Due to Envelopment and Compression by an Inflammatory Retroperitoneal Process , J Urol 59:1072, 1948. 2. Tactac, A.Y., and Thuman, R.C., Jr.: Electrolyte Balance Following Relief of Chronic Urinary Tract Obstruction , Surg Clin N Amer 39:1661, 1959. 3. Eiseman, B.; Vivion, C.; and Vivian, J.: Fluid and Electrolyte Changes Following Relief of Urinary Obstruction , J Urol 74:222. 1955. 4. Wilson, B.; Riseman, D.; and Mayer, C.: Fluid Balance in Urological Patient: Disturbances in the Renal Regulation of the Excretion of Water and Sodium Salts Following Decompression of the Urinary Bladder , J Urol 66:805, 1951. 5. Hinman, F.: Hydronephrosis: I. The Structural Changes , Surgery 17:816, 1945. 6. Hinman, F.: Hydronephrosis: II. The Functional Changes , Surgery 17:836, 1945. 7. Bricker, N., et al: An Abnormality in Renal Function Resulting From Urinary Tract Obstruction , Amer J Med 23:554, 1957.Crossref 8. Stewart, J.; Stewart, W.; and Gillie, H.: Cardiac Arrest and Acidosis , Lancet 283:964, 1962.Crossref 9. Maher, J.F.; Schreiner, G.E.; and Waters, T.J.: Osmotic Diuresis Due to Retained Urea After Release of Obstructive Uropathy , New Eng J Med 268:1099, 1963.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1966

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