Retroperitoneal fibrosis.

Retroperitoneal fibrosis may be classified as either primary or idiopathic, probably of autoimmune origin or secondary to a malignant process. Both classes are usually presented identically, and it is the responsibility of the physician to exclude a malignant process. The disease should be especially suspected in patients with signs and symptoms of irritation of the retroperitoneal space, such as pain in the lower part of the back or in the flank, a distribution of pain down the legs and, at times, a positive Patrick's sign. Gray scale ultrasonography and computerized axial tomography may now be used to help in the diagnosis of this entity and also in the follow-up management. Operation is recommended for diagnosis and correction of any ureteral impairment. Steroids may be an invaluable aid for the treatment of this disease.