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Postpartum Retroperitoneal Fibrosis With IVC Obstruction: A Case Report.

Roy Clark Basiimwa¹, Samuel Bugeza¹, Rita Nassanga¹

¹Department of Radiology, School of Medicine, Makerere University, Kampala, Uganda, mak.ac.ug.

Case Reports in Radiology

|July 2, 2026

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Retroperitoneal fibrosis (RPF) is a rare condition. This case highlights an unusual presentation in a young woman postpartum, suggesting immune system reactivation may trigger RPF.

Area of Science:

Medicine
Immunology
Radiology

Background:

Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory condition.
It typically affects middle-aged men and can be linked to IgG-4-related disease (IgG-4 RD).
RPF can obstruct vital retroperitoneal structures like vessels and ureters.

Purpose of the Study:

To report an unusual case of RPF in a young woman.
To explore potential immunologic triggers for RPF.
To discuss diagnostic findings and management strategies.

Main Methods:

Case report of a 34-year-old woman presenting postpartum.
Contrast-enhanced CT and MRI were used for diagnosis.
Treatment involved thrombolytics, steroids, nephrostomy, and urological intervention.

Keywords:

autoimmune disease postpartum retroperitoneal fibrosis

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Main Results:

A homogenous retroperitoneal mass encasing major arteries and obstructing the IVC was identified.
MRI showed characteristic findings of hypointensity on T2-weighted imaging and restricted diffusion.
Treatment led to IVC recanalization but persistent hydronephrosis required further intervention.

Conclusions:

RPF presentation in young women is atypical.
Postpartum immune system reactivation is theorized as a potential trigger for RPF.
This case underscores the diverse immunologic factors associated with RPF.