Introduction. The natural course of abdominal aneurysms is progressive
expansion, rupture, embolisation, thrombosis and compression of the visceral
organs. The majority of papers report that inflammatory aortic and iliac
aneurysms are associated with perianeurysmal and retroperitoneal fibrosis
that ultimately results in the structural compromise of the urinary tract.
Ureteral obstruction occurs in 20% to 71% of cases and approximately one half
of these patients will present with obstructive uropathy. Most patients with
inflammatory aneurysm are symptomatic, with elevated serum inflammatory
markers, and characteristic multislice CT findings including a thickened
aortic wall and a mass of periaortic inflammatory tissue. Case Outline. A
70-year-old man was admitted at the Vascular Surgery Clinic ?Dedinje?,
Belgrade, because of ultrasonically verified asymptomatic aortoiliac
aneurysm. Multisclice CT findings showed left urethral dilatation and
hydronephrosis secondary to extrinsic ureteral obstruction due to aortoiliac
aneurysm. CT findings, laboratory tests and finally, histopathologic
examination showed atherosclerotic aneurysm without inflammation and
retroperitoneal fibrosis. The patient was successfully treated with surgical
resection of the aneurysm and aortobiiliac reconstruction with ?Y?
prosthesis. Conclusion. We present a rare case of ureteral obstruction
secondary to atherosclerotic aneurysm which, to our knowledge, has not been
previously described in the domestic literature. A successful operative
repair was performed. Postoperative course was uneventful and the patient was
discharged on the seventh day after the surgery with normal vascular status
and renal function.
RETROPERITONEAL FIBROSIS PRESENTING AS URETERAL OBSTRUCTION SECONDARY TO SARCOIDOSIS
