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[Chronic periaortitis].
- Source :
-
Der Internist [Internist (Berl)] 2013 Dec; Vol. 54 (12), pp. 1419-20, 1422, 1424-6. - Publication Year :
- 2013
-
Abstract
- Chronic periaortitis is an inflammatory and fibrosing disease presenting as periaortal fibrosis and formation of aortic aneurysms which are mostly localized in the retroperitoneum and occasionally in the mediastinum. Inflammatory vasculitic involvement of large vessels is also possible. In addition to symptoms of systemic inflammation, mechanical complications also occur whereby obstruction of the ureter is the most frequent. The diagnosis is made by contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) and if the findings are atypical the diagnosis should be confirmed by biopsy. After exclusion of a secondary genesis, in which case therapy of the underlying illness would be necessary, idiopathic chronic periaortitis can be treated with steroids. In cases of refractory and relapsing courses the administration of further immunosuppressive medication can be necessary. Duration of therapy, dosage and indications for immunosuppressive medication are currently unclear and have to be defined in further randomized controlled trials with larger cohorts. If complications occur, interventional or operative treatment can be necessary; in cases of hydronephrosis the placement of double-J-stents is usually sufficient.
- Subjects :
- Aortic Aneurysm diagnosis
Aortic Aneurysm etiology
Humans
Immunosuppressive Agents therapeutic use
Magnetic Resonance Imaging methods
Retroperitoneal Fibrosis complications
Steroids therapeutic use
Tomography, X-Ray Computed methods
Ureteral Obstruction etiology
Retroperitoneal Fibrosis diagnosis
Retroperitoneal Fibrosis therapy
Ureteral Obstruction diagnosis
Ureteral Obstruction therapy
Subjects
Details
- Language :
- German
- ISSN :
- 1432-1289
- Volume :
- 54
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Der Internist
- Publication Type :
- Academic Journal
- Accession number :
- 24253388
- Full Text :
- https://doi.org/10.1007/s00108-013-3297-5