Vol 80, No 3 (2021)
Case report
Published online: 2020-07-29

open access

Page views 6762
Article views/downloads 1091
Get Citation

Connect on Social Media

Connect on Social Media

A case of solitary kidney with duplex collecting systems and renal vascular variants in an adult male cadaver

M. S. Salimy1, G. A. Luiselli1, M. Yuen1, R. C. Healy1, S. G. Shah1, E. L. Giannaris1, M. Das1, A. E. Wink1
Pubmed: 32748948
Folia Morphol 2021;80(3):722-725.

Abstract

We describe a unique solitary kidney with duplex collecting system and vascular variation observed in an 86-year-old white male formaldehyde- and phenol-fixed cadaver during routine academic dissection. The left renal fossa was empty with an intact adrenal gland, and the right renal fossa contained a fused renal mass with apparent polarity between the superior and inferior regions and two renal pelves converging into a single ureter. There were three right renal arteries supplying the renal mass; the superior and middle arteries were noted to be postcaval and the inferior artery was precaval. There were also two right renal veins draining into the inferior vena cava and following a regional distribution with the superior vein draining the inferior portion of the renal mass. Despite generally being asymptomatic, the detection of renal anatomical variants is clinically important for appropriate patient management and surgical interventions.

Article available in PDF format

View PDF Download PDF file

References

  1. Alberts VP, Minnee RC, van Donselaar-van der Pant KAMI, et al. Duplicated ureters and renal transplantation: a case-control study and review of the literature. Transplant Proc. 2013; 45(9): 3239–3244.
  2. Chakravarthi KK, Karuneswari DP, Uma MN. Congenital unilateral double renal pelvis and double ureters associated with triple renal veins and left retro aortic renal vein. Int J Chem Life Sci. 2013; 2(5): 1159–1162.
  3. Chawla K, Gupta R, Singh HJ, et al. Bilateral bifid ureter with unilateral renal vasculature variations. Surg Radiol Anat. 2014; 36(4): 393–396.
  4. Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diag Interv Imaging. 2016; 97(9): 891–897.
  5. Das S, Dhar P, Mehra RD. Unilateral isolated bifid ureter — a case report. J Anat Soc India. 2001; 50(1): 43–44.
  6. de Virgilio C, Gloviczki P, Cherry KJ, et al. Renal artery anomalies in patients with horseshoe or ectopic kidneys: the challenge of aortic reconstruction. Cardiovasc Surg. 1995; 3(4): 413–420.
  7. Gulas E, Wysiadecki G, Cecot T, et al. Accessory (multiple) renal arteries - Differences in frequency according to population, visualizing techniques and stage of morphological development. Vascular. 2016; 24(5): 531–537.
  8. Horai K, Naito M, Yakura T, et al. A case of pancake kidney with a single ureter in the retroperitoneal space. Anat Sci Int. 2018; 93(4): 563–565.
  9. Kanchan T, Murlimanju BV, Saralaya VV. Pancake kidney with a single ureter: a rare incidental observation at autopsy. Anat Sci Int. 2017; 92(1): 142–146.
  10. Kannabathula A, Rai G, Singh KC, et al. Unilateral double pelvis bifid ureter associated with multiple variations of renal vessels. Int J Anat Res. 2016; 4(4.2): 3100–3104.
  11. Kaufman MH, Findlater GS. An unusual case of complete renal fusion giving rise to a 'cake' or 'lump' kidney. J Anat. 2001; 198(Pt 4): 501–504.
  12. Khanduri S, Tyagi E, Yadav VK, et al. Crossed fused renal ectopia with single ureter and single renal vein: a rare case. Cureus. 2019; 11(1): e3914.
  13. Loganathan AK, Bal HS. Crossed fused renal ectopia in children: a review of clinical profile, surgical challenges, and outcome. J Pediatr Urol. 2019; 15(4): 315–321.
  14. Mathews R, Smith PA, Fishman EK, et al. Anomalies of the inferior vena cava and renal veins: embryologic and surgical considerations. Urology. 1999; 53(5): 873–880.
  15. Matusz P, Miclaus GD, Banciu CD, et al. Congenital solitary kidney with multiple real arteries: case report using MDCT angiography. Rom J Morphol Embryol. 2015; 56(2 Suppl): 823–826.
  16. Miclaus GD, Pupca G, Gabriel A, et al. Right lump kidney with varied vasculature and urinary system revealed by multidetector computed tomographic (MDCT) angiography. Surg Radiol Anat. 2015; 37(7): 859–865.
  17. Palit S, Datta AK, Tapadar AA. Rare presentation of rudimentary ectopic right kidney fused to the lower pole of the left with multiple aberrant renal vessel – a case report. J Anat Soc India. 2008; 57(2): 146–150.
  18. Pupca G, et al. Left crossed fused renal ectopia L-shaped kidney type, with double nutcracker syndrome (anterior and posterior). Rom J Morphol Embryol. 2014; 55: 1237–1241.
  19. Satyapal KS, Haffejee AA, Singh B, et al. Additional renal arteries: incidence and morphometry. Surg Radiol Anat. 2001; 23(1): 33–38.
  20. Shapiro E, Goldfarb DA, Ritchey ML. The congenital and acquired solitary kidney. Rev Urol. 2003; 5(1): 2–8.
  21. Stojadinovic D, Zivanovic-Macuzic I, Sazdanovic P, et al. Concomitant multiple anomalies of renal vessels and collecting system. Folia Morphol. 2020; 79(3): 627–633.
  22. Tubbs RS, Shoja MM, Loukas M. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation. John Wiley & Sons, Hoboken NJ 2016.