A 60-year-old man visited our hospital with the chief complaint of
right flank pain. A right ureteral stone was suspected by the findings of KUB and DIP, and
conservative treatment was carried out. Repeat KUB and DIP a month
after treatment showed that the stone shadow was not visible and right
hydronephrosis had increased. Closer examinations by RP and CT scan revealed right
ureteral obstruction caused by periarterial
fibrosis accompanied with arteriosclerotic changes of the aortoiliac region. The arteriosclerotic changes were confirmed by pelvic arteriography, and then right ureterolysis and lateral displacement were performed. DIP four months after the operation showed improvement of right
hydronephrosis, but left
hydronephrosis was observed. As the same cause as the right side was suspected, left ureterolysis and intraperitoneal transposition were also performed. Histological findings of each periureteral tissue resembled
idiopathic retroperitoneal fibrosis. DIP three months after the second operation showed no
hydronephrosis. Case reports of
ureteral obstruction due to perianeurysmal
fibrosis have not been infrequent recently, but our case showed severe arteriosclerotic changes instead of conspicuous
aneurysm. The possibility of occurrence of periarterial
fibrosis caused by severe arteriosclerotic changes is discussed.