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Ahead of Print
Case report
Submitted: 2021-08-18
Accepted: 2021-09-24
Published online: 2021-10-07
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A unique case of extrarenal calyces and associated vascular variations in an adult female cadaver

S. Ahuja1, N. Maglasang1, Y. Tan1, D. T. Daly1
DOI: 10.5603/FM.a2021.0099
·
Pubmed: 34642933
Affiliations
  1. Center for Anatomical Science and Education, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA

open access

Ahead of Print
CASE REPORTS
Submitted: 2021-08-18
Accepted: 2021-09-24
Published online: 2021-10-07

Abstract

The following urogenital and vascular anomalies were observed in the left kidney of an 81-year-old female cadaver during routine dissection: three extrarenal calyces; an accessory renal artery originating directly from the abdominal aorta; and a circumaortic renal vein.

The typical renal anatomical structures were identified, from anterior to posterior, as the renal vein, renal artery, and ureter appearing near the hilum of the left kidney. After closer examination, three extrarenal calyces were observed exiting from the hilum of the left kidney to form the pelvis, then narrowed and became the ureter which descended 21.5 cm to empty into the bladder. The accessory renal artery originated from the lateral aspect of the abdominal aorta 7.3 cm below the aortic origin of the left renal artery. A corresponding accessary renal vein, identified as a circumaortic vein, left the hilum 4.5 cm below the left renal vein and traveled posterior to the abdominal aorta to drain into the inferior vena cava.

Extrarenal calyces are rare among urogenital tract variations. They can be associated with embryological abnormalities such as renal ectopia, horseshoe kidney or malrotation as well as clinical manifestations such as pelviureteric junction obstruction and hydronephrosis. Compression of the accessory renal artery can cause decreased blood flow to the inferior pole of the left kidney, thereby causing fibrosis, atrophy, or renal failure. The retro-aortic path of the circumaortic renal vein has been associated with posterior nutcracker phenomenon, hematuria, left renal vein thrombus formation, and renal vein hypertension. This unique combination of a collecting system anomaly and extrarenal vessel variations could have significant implications in abdominal surgery.

Abstract

The following urogenital and vascular anomalies were observed in the left kidney of an 81-year-old female cadaver during routine dissection: three extrarenal calyces; an accessory renal artery originating directly from the abdominal aorta; and a circumaortic renal vein.

The typical renal anatomical structures were identified, from anterior to posterior, as the renal vein, renal artery, and ureter appearing near the hilum of the left kidney. After closer examination, three extrarenal calyces were observed exiting from the hilum of the left kidney to form the pelvis, then narrowed and became the ureter which descended 21.5 cm to empty into the bladder. The accessory renal artery originated from the lateral aspect of the abdominal aorta 7.3 cm below the aortic origin of the left renal artery. A corresponding accessary renal vein, identified as a circumaortic vein, left the hilum 4.5 cm below the left renal vein and traveled posterior to the abdominal aorta to drain into the inferior vena cava.

Extrarenal calyces are rare among urogenital tract variations. They can be associated with embryological abnormalities such as renal ectopia, horseshoe kidney or malrotation as well as clinical manifestations such as pelviureteric junction obstruction and hydronephrosis. Compression of the accessory renal artery can cause decreased blood flow to the inferior pole of the left kidney, thereby causing fibrosis, atrophy, or renal failure. The retro-aortic path of the circumaortic renal vein has been associated with posterior nutcracker phenomenon, hematuria, left renal vein thrombus formation, and renal vein hypertension. This unique combination of a collecting system anomaly and extrarenal vessel variations could have significant implications in abdominal surgery.

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Keywords

renal vein, renal artery, kidney, extrarenal calyces, CAKUT

About this article
Title

A unique case of extrarenal calyces and associated vascular variations in an adult female cadaver

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2021-10-07

Page views

444

Article views/downloads

209

DOI

10.5603/FM.a2021.0099

Pubmed

34642933

Keywords

renal vein
renal artery
kidney
extrarenal calyces
CAKUT

Authors

S. Ahuja
N. Maglasang
Y. Tan
D. T. Daly

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