Intermittent Claudication Secondary to Idiopathic Fibrous Retroperitonitis

PROGRESSIVE eneasement and compression of the retroperitoneal structures by an extensive fibrosing process of uncertain etiology referred to as idiopathic fibrous retroperitonitis was first reported in the English literature in 1948.1 Since that time, more than 100 cases have been reported, and, in the majority, initial or subsequent symptoms were related to the urinary tract as a result of partial or complete ureteral obstruction. It is not uncommon for the aorto-iliac arteries to be embedded within the proliferating fibrous tissue, although isehemic symptoms have not been a conspicuous aspect of the disease.2 3 Several case reports indicate that partial occlusion of the terminal aorta was aln incidental finding at operation4' 5 or necropsy,4' 6 and, in one case, from an aortogram made to assess the renal vasculature. The following case is presented to alert physicians to the possibility that idiopathic fibrous retroperitonitis can be manifested primarily as an aorto-iliac occlusive disease alnd to emphasize the relative ease and safety with which the obstruction can be relieved by the proper surgical measures.