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Retroperitoneal inflammation

Retroperitonitis

Retroperitoneal inflammation causes swelling that occurs in the retroperitoneal space. Over time, it can lead to a mass behind the abdomen called retroperitoneal fibrosis.

The retroperitoneal space is in front of the lower back and behind the abdominal lining (peritoneum). Organs in this space include the:

  • Kidneys
  • Lymph nodes
  • Pancreas
  • Spleen
  • Ureters

Causes

Retroperitoneal inflammation and fibrosis is a rare condition. There is no clear cause in about 70% of cases.

Conditions that can rarely lead to this include:

  • Abdominal radiation therapy for cancer
  • Cancer: bladder, breast, colon, lymphoma, prostate, sarcoma
  • Crohn disease
  • Infections: tuberculosis, histoplasmosis
  • Certain medicines
  • Surgery of structures in the retroperitoneum

Symptoms

Symptoms include:

  • Abdominal pain
  • Anorexia
  • Flank pain
  • Low back pain
  • Malaise

Exams and Tests

Your health care provider usually diagnoses the condition based on a CT scan or ultrasound exam of your abdomen. A biopsy of tissues in your abdomen may be needed.

Treatment

Treatment depends on the underlying cause of retroperitoneal inflammation and fibrosis.

Outlook (Prognosis)

How well you do with the condition depends on the underlying cause. It can lead to kidney failure.

References

Mettler FA, Guiberteau MJ. Inflammation and infection imaging. In: Mettler FA, Guiberteau MJ, eds. Essentials of Nuclear Medicine and Molecular Imaging. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 12.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 132.

Turnage RH, Mizell J, Badgwell B. Abdominal wall, umbilicus, peritoneum, mesenteries, omentum, and retroperitoneum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 43.

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      Review Date: 10/12/2018

      Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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