open access

Vol 79, No 3 (2020)
Case report
Submitted: 2019-08-11
Accepted: 2019-09-27
Published online: 2019-10-09
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Concomitant multiple anomalies of renal vessels and collecting system

D. Stojadinovic1, I. Zivanovic-Macuzic1, P. Sazdanovic1, D. Jeremic1, M. Jakovcevski1, M. Minic1, M. Kovacevic1
·
Pubmed: 31617578
·
Folia Morphol 2020;79(3):627-633.
Affiliations
  1. Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

open access

Vol 79, No 3 (2020)
CASE REPORTS
Submitted: 2019-08-11
Accepted: 2019-09-27
Published online: 2019-10-09

Abstract

Although anomalies of renal vessels and collecting system are relatively frequent, their concomitant occurrence is a rare event. During dissection of a 75-year-old male formalin-embalmed cadaver, we found multiple variations in the renal vessels and renal collecting system. Both kidneys were normal in size and anteriorly malrotated, with duplex collecting system and duplex ureter. One ureter drained the upper part of the kidney and the second ureter drained the lower part of the kidney. Superior and inferior collecting systems were separated by renal parenchyma. The right kidney had two renal arteries, the first renal artery (main renal artery) originating from the abdominal aorta, passing behind the inferior vena cava (IVC) and entering the kidney through the superior and inferior renal hilum. The second artery was the inferior polar artery. In addition, the right kidney had two renal veins as well. Three renal tributaries emerged from the upper and lower portion of the right renal hilum, and they joined to form the main renal vein which drained into the IVC. The lower renal vein was the inferior polar vein. The left kidney had four renal arteries (two hilar arteries and two polar arteries). The main left renal vein emerged from both superior and inferior left renal hilum, passed in front of the abdominal aorta and drained into the IVC. The left kidney also had the inferior polar vein which was divided behind the aorta (retro aortic vein) into two venous trunks. These venous trunks drained separately into posteromedial
aspect of the IVC. Finally, the right testicular vein was formed by two tributaries and drained into the IVC, whereas the two left testicular veins drained separately into the left main renal vein.

Abstract

Although anomalies of renal vessels and collecting system are relatively frequent, their concomitant occurrence is a rare event. During dissection of a 75-year-old male formalin-embalmed cadaver, we found multiple variations in the renal vessels and renal collecting system. Both kidneys were normal in size and anteriorly malrotated, with duplex collecting system and duplex ureter. One ureter drained the upper part of the kidney and the second ureter drained the lower part of the kidney. Superior and inferior collecting systems were separated by renal parenchyma. The right kidney had two renal arteries, the first renal artery (main renal artery) originating from the abdominal aorta, passing behind the inferior vena cava (IVC) and entering the kidney through the superior and inferior renal hilum. The second artery was the inferior polar artery. In addition, the right kidney had two renal veins as well. Three renal tributaries emerged from the upper and lower portion of the right renal hilum, and they joined to form the main renal vein which drained into the IVC. The lower renal vein was the inferior polar vein. The left kidney had four renal arteries (two hilar arteries and two polar arteries). The main left renal vein emerged from both superior and inferior left renal hilum, passed in front of the abdominal aorta and drained into the IVC. The left kidney also had the inferior polar vein which was divided behind the aorta (retro aortic vein) into two venous trunks. These venous trunks drained separately into posteromedial
aspect of the IVC. Finally, the right testicular vein was formed by two tributaries and drained into the IVC, whereas the two left testicular veins drained separately into the left main renal vein.

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Keywords

anatomy; variation; renal artery; renal vein; kidney

About this article
Title

Concomitant multiple anomalies of renal vessels and collecting system

Journal

Folia Morphologica

Issue

Vol 79, No 3 (2020)

Article type

Case report

Pages

627-633

Published online

2019-10-09

Page views

1302

Article views/downloads

883

DOI

10.5603/FM.a2019.0108

Pubmed

31617578

Bibliographic record

Folia Morphol 2020;79(3):627-633.

Keywords

anatomy
variation
renal artery
renal vein
kidney

Authors

D. Stojadinovic
I. Zivanovic-Macuzic
P. Sazdanovic
D. Jeremic
M. Jakovcevski
M. Minic
M. Kovacevic

References (42)
  1. Alberts VP, Minnee RC, van Donselaar-van der Pant KA, et al. Duplicated ureters and renal transplantation: a case-control study and review of the literature. Transplant Proc. 2013; 45(9): 3239–3244.
  2. Aljabri B, MacDonald PS, Satin R, et al. Incidence of major venous and renal anomalies relevant to aortoiliac surgery as demonstrated by computed tomography. Ann Vasc Surg. 2001; 15(6): 615–618.
  3. Anjamrooz SH, Azari H, Abedinzadeh M. Abnormal patterns of the renal veins. Anat Cell Biol. 2012; 45(1): 57–61.
  4. Anson BJ, Daseler EH. Common variations in renal anatomy, affecting blood supply, form, and topography. Surg Gynecol Obstet. 1961; 112: 439–449.
  5. Asala S, Chaudhary S, Masumbuko-Kahamba N, et al. Anatomical variations in the human testicular blood vessels. Ann Anat. 2001; 183(6): 545–549.
  6. Ballesteros LE, Saldarriaga V, Ramirez LM. Morphologic evaluation of the renal veins: a study with autopsy material from Colombian subjects. Rom J Morphol Embryol. 2014; 55(1): 77–81.
  7. Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging. 2016; 97(9): 891–897.
  8. Eldefrawy A, Arianayagam M, Kanagarajah P, et al. Anomalies of the inferior vena cava and renal veins and implications for renal surgery. Cent European J Urol. 2011; 64(1): 4–8.
  9. Gao Z, Wu J, Lin C, et al. Transperitoneal laparoscopic heminephrectomy in duplex kidney: our initial experience. Urology. 2011; 77(1): 231–236.
  10. Gay SB, Armistead JP, Weber ME, et al. Left infrarenal region: anatomic variants, pathologic conditions, and diagnostic pitfalls. Radiographics. 1991; 11(4): 549–570.
  11. Graves FT. The aberrant renal artery. J Anat. 1956; 90(4): 553–558.
  12. 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.
  13. Gundeti MS, Ransley PG, Duffy PG, et al. Renal outcome following heminephrectomy for duplex kidney. J Urol. 2005; 173(5): 1743–1744.
  14. Hlaing KP, Das S, Sulaiman IM, et al. Accessory renal vessels at the upper and lower pole of the kidney: a cadaveric study with clinical implications. Bratisl Lek Listy. 2010; 111(5): 308–310.
  15. Holden A, Smith A, Dukes P, et al. Assessment of 100 live potential renal donors for laparoscopic nephrectomy with multi-detector row helical CT. Radiology. 2005; 237(3): 973–980.
  16. Ichikawa T, Iino M, Koizumi J, et al. A case of right renal artery originating from the thoracic aorta. Jpn J Radiol. 2014; 32(12): 716–720.
  17. Janschek ECS, Rothe AU, Hölzenbein TJ, et al. Anatomic basis of right renal vein extension for cadaveric kidney transplantation. Urology. 2004; 63(4): 660–664.
  18. Kadotani Y, Okamoto M, Akioka K, et al. Management and outcome of living kidney grafts with multiple arteries. Surg Today. 2005; 35(6): 459–466.
  19. Karazincir S, Balci A, Görür S, et al. Incidence of the retroaortic left renal vein in patients with varicocele. J Ultrasound Med. 2007; 26(5): 601–604.
  20. Kinnunen J, Tötterman S, Tervahartiala P. Ten renal arteries. Eur J Radiol. 1985; 5(4): 300–301.
  21. Koc Z, Ulusan S, Oguzkurt L, et al. Venous variants and anomalies on routine abdominal multi-detector row CT. Eur J Radiol. 2007; 61(2): 267–278.
  22. Koc Z, Ulusan S, Oguzkurt L. Association of left renal vein variations and pelvic varices in abdominal MDCT. Eur Radiol. 2007; 17(5): 1267–1274.
  23. Kornafel O, Baran B, Pawlikowska I, et al. Analysis of anatomical variations of the main arteries branching from the abdominal aorta, with 64-detector computed tomography. Pol J Radiol. 2010; 75(2): 38–45.
  24. Ozkan U, Oğuzkurt L, Tercan F, et al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2006; 12(4): 183–186.
  25. Palmieri BJ, Petroianu A, Silva LC, et al. Study of arterial pattern of 200 renal pedicle through angiotomography. Rev Col Bras Cir. 2011; 38(2): 116–121.
  26. Privett JT, Jeans WD, Roylance J. The incidence and importance of renal duplication. Clin Radiol. 1976; 27(4): 521–530.
  27. Satyapal KS, Kalideen JM, Haffejee AA, et al. Left renal vein variations. Surg Radiol Anat. 1999; 21(1): 77–81.
  28. Satyapal KS, Haffejee AA, Singh B, et al. Additional renal arteries: incidence and morphometry. Surg Radiol Anat. 2001; 23(1): 33–38.
  29. Sebastià C, Peri L, Salvador R, et al. Multidetector CT of living renal donors: lessons learned from surgeons. Radiographics. 2010; 30(7): 1875–1890.
  30. Standring S. (Ed). Gray’s Anatomy-The Anatomical Basis of Clinical Practice. Elsevier Churchill Livingstone Publishers, London 2005.
  31. Stephens F. Ureterovascular hydronephrosis and the “aberrant” renal vessels. J Urol. 1982; 128(5): 984–987.
  32. Stinson JM, Rivard AL, Mitchell ME. Intrathoracic origin of the left renal artery. J Vasc Surg. 2016; 64(6): 1851–1852.
  33. Tardo DT, Briggs C, Ahern G, et al. Anatomical variations of the renal arterial vasculature: An Australian perspective. J Med Imaging Radiat Oncol. 2017; 61(5): 643–649.
  34. Türkvatan A, Ozdemir M, Cumhur T, et al. Multidetector CT angiography of renal vasculature: normal anatomy and variants. Eur Radiol. 2009; 19(1): 236–244.
  35. Türkvatan A, Akinci S, Yildiz S, et al. Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors. Surg Radiol Anat. 2009; 31(4): 227–235.
  36. Ugurel MS, Battal B, Bozlar U, et al. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol. 2010; 83(992): 661–667.
  37. Urban BA, Ratner LE, Fishman EK. Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants, and clinical applications. Radiographics. 2001; 21(2): 373–386.
  38. Williams H. Renal revision: from lobulation to duplication--what is normal? Arch Dis Child Educ Pract Ed. 2007; 92(5): ep152–ep158.
  39. Wróbel G, Spałek M, Kuchinka J, et al. Four left renal arteries - a rare variant of kidney arterial supply. Folia Morphol. 2019; 78(1): 208–213.
  40. Yagel S, Kivilevitch Z, Cohen SM, et al. The fetal venous system, part I: normal embryology, anatomy, hemodynamics, ultrasound evaluation and Doppler investigation. Ultrasound Obstet Gynecol. 2010; 35(6): 741–750.
  41. Zhang Q, Ji Y, He T, et al. Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient. Diagn Pathol. 2012; 7: 176.
  42. Zhu J, Zhang L, Yang Z, et al. Classification of the renal vein variations: a study with multidetector computed tomography. Surg Radiol Anat. 2015; 37(6): 667–675.

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