Retroperitoneal Fibrosis with Duodenal Obstruction Mimicking Duodenal Cancer: A Case Report

Abstract

Introduction: Retroperitoneal fibrosis is a rare disease with mainly ureteral obstruction. Here, we present a case of retroperitoneal fibrosis which was difficult to distinguish from duodenal cancer. Method: A 64-year-old woman was admitted to the emergency room because of persistent vomiting due to duodenal obstruction. The duodenum was narrowed enough that the endoscope could not pass through. Abdominal CT scan revealed duodenal cancer and pancreaticoduodenectomy was performed. Result: Pathologic examination revealed encircling fibrosis of duodenum and there was no evidence of malignancy. Postoperatively, gastrojejunostomy site stricture was occurred 10 days after initial surgery. Gastrojejunal bypass was performed on postoperative 25th day. However, there was newly developed fibrosis on follow up CT image. We performed steroid treatment for retroperitoneal fibrosis and the patient was recovered without obstructive symptoms. Conclusion: Even if duodenal cancer is suspected in preoperative imaging studies, differential diagnosis of retroperitoneal fibrosis is necessary.