Abdominal aortic aneurysm with retroperitoneal fibrosis and ureteric entrapment

Eleven of 157 patients undergoing surgery for abdominal aortic aneurysm, with features of both aneurysm and periaortic retroperitoneal fibrosis, are presented. The clinical details, implications and management are reported. The possibility that this association may present with differing relative severity of these two conditions is discussed. aortic replacement is advocated as the treatment of choice because the risk of rupture still exists and this procedure seems to halt, or even reverse, the inflammatory process. Synchronous ureterolysis is reasonably safe and can be undertaken if obstruction is present. Steroids represent an alternative option, where aortic replacement is too hazardous.