Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202301202
Jornal Vascular Brasileiro
Case Report

A rare case of multiple visceral vascular variations around the kidneys: morphological and clinical aspects

Um caso raro de múltiplas variações vasculares viscerais ao redor dos rins: aspectos morfológicos e clínicos

Dibakar Borthakur; Mohammed Ahmed Ansari; Neerja Rani; Rajesh Kumar; Monica Baxla

Downloads: 0
Views: 142

Abstract

Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is important information for planning any surgeries in the region. We present here a rare constellation of variations of visceral vessels around the kidneys with a brief review of the recent literature. On the right side, an accessory renal artery was observed originating just distal to the main renal artery. The middle suprarenal artery was absent on the right side and there were two inferior suprarenal arteries originating from a branch of the main right renal artery. On the left side, the testicular artery had an arched course anterior to the left renal vein mimicking an unusual variety of nutcracker phenomenon. The right kidney was drained by two renal veins into the inferior vena cava. Knowledge of the coexistence of such complex anatomical variations might be helpful for clinicians during diagnostic and therapeutic procedures.

Keywords

anatomical variation, kidney, renal vein, suprarenal, testicular artery

Resumo

O conhecimento das variações anatômicas dos ramos viscerais da aorta abdominal é uma informação importante para o planejamento de qualquer cirurgia nessa região. Neste relato, apresentamos um raro conjunto de variações de vasos viscerais ao redor dos rins, bem como uma breve revisão da literatura recente. No lado direito, foi observada uma artéria renal acessória originando-se distal à artéria renal principal. Não havia artéria suprarrenal média no lado direito, e havia duas artérias suprarrenais inferiores originando-se de um ramo da artéria renal direita. No lado esquerdo, a artéria testicular apresentava um curso arqueado anterior à veia renal esquerda, simulando uma variedade incomum do fenômeno do quebra-nozes. O rim direito era drenado por duas veias renais para a veia cava inferior. O conhecimento da coexistência de tais variações anatômicas complexas pode ser útil para os clínicos durante os procedimentos diagnósticos e terapêuticos.

Palavras-chave

variação anatômica, rim, veia renal, suprarrenal, artéria testicular

References

1 Tardo DT, Briggs C, Ahern G, Pitman A, Sinha S. Anatomical variations of the renal arterial vasculature: an Australian perspective. J Med Imaging Radiat Oncol. 2017;61(5):643-9. http://dx.doi.org/10.1111/1754-9485.12618. PMid:28466967.

2 Budhiraja V, Rastogi R, JainV, Bankwar V. Anatomical variations of renal artery and its clinical correlations: a cadaveric study from central India. J Morphol Sci.2013;30:228-33.

3 Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV, Kalideen JM. Additional renal arteries incidence and morphometry. Surg Radiol Anat. 2001;23(1):33-8. http://dx.doi.org/10.1007/s00276-001-0033-y. PMid:11370140.

4 Papaloucas C, Fiska A, Demetriou T. Additional renal arteries. Clin Anat. 2007;20(4):475-475. http://dx.doi.org/10.1002/ca.20465. PMid:17309064.

5 Lama CP, Pradhan A. Variations of renal artery in cadavers. Nepal Med Coll J. 2019;21(3):214-9. http://dx.doi.org/10.3126/nmcj.v21i3.26461.

6 Aristotle S, Sundarapandian, Felicia C. Anatomical study of variations in the blood supply of kidneys.J Clin Diagn Res. 2013;7(8):1555-7. PMid:24086837.

7 Notkovich H. Testicular artery arching over renal vein: clinical and pathological considerations with special reference to varicocele. Br J Urol. 1955;27(3):267-71. http://dx.doi.org/10.1111/j.1464-410X.1955.tb03479.x. PMid:13269815.

8 Kumar N, Padur AA, Kappettu Gadahad MR, Shanthakumar SR. Clinically important left superior polar artery giving rise to a left inferior suprarenal artery and an aberrant left inferior polar artery: a case report.J Vasc Bras. 2023;22:4-7. http://dx.doi.org/10.1590/1677-5449.202300122. PMid:37576723.

9 Cho Y, Yoon SP. Bilateral inferior renal polar arteries with a high origin from the abdominal aorta. Folia Morphol (Warsz). 2021;80(1):215-8. http://dx.doi.org/10.5603/FM.a2020.0040. PMid:32301105.

10 Karadağ C, Birge O, Bakir MS, Doğan S, Tuncer HA, Şimşek T. Encountering the accessory polar renal artery during retroperitoneal lymphadenectomy. Clin Case Rep. 2020;177-179(1):177-9. http://dx.doi.org/10.1002/ccr3.3493. PMid:33505687.

11 Lee WM, Choi JS, Bae J, Jung US, Eom JM. Encountering the accessory polar renal artery during laparoscopic para-aortic lymphadenectomy. J Minim Invasive Gynecol. 2018;25(1):10-1. http://dx.doi.org/10.1016/j.jmig.2017.03.015. PMid:28347879.

12 El-Sherbiny M, Abou-Elela A, Morsy A, Salah M, Foda A. The use of the inferior epigastric artery for accessory lower polar artery revascularization in live donor renal transplantation. Int Urol Nephrol. 2008;40(2):283-7. http://dx.doi.org/10.1007/s11255-007-9257-z. PMid:17721826.

13 Vilhova I, Kryvko YY, Maciejewski R. The radioanatomical research of plural renal arteries. Folia Morphol (Warsz). 2001;60(4):337-41. PMid:11770346.

14 Funes Hernandez M, Bhalla V, Isom RT. Hypothesis: accessory renal arteries may be an overlooked cause of renin-dependent hypertension. J Hum Hypertens. 2022;36(5):493-7. http://dx.doi.org/10.1038/s41371-021-00632-2. PMid:34785773.

15 Manso JC, DiDio LJA. Anatomical variations of the human suprarenal arteries. Ann Anat. 2000;182(5):483-8. http://dx.doi.org/10.1016/S0940-9602(00)80064-3. PMid:11035646.

16 Priya A, Narayan RK, Ghosh SK. Prevalence and clinical relevance of the anatomical variations of suprarenal arteries: a review. Anat Cell Biol. 2022;55(1):28-39. http://dx.doi.org/10.5115/acb.21.211. PMid:35046145.

17 Kayalvizhi I, Narayan RK, Kumar P. Anatomical variations of testicular artery: a review. Folia Morphol (Warsz). 2017;76(4):541-50. http://dx.doi.org/10.5603/FM.a2017.0035. PMid:28394009.

18 Naito M, Terayama H, Nakamura Y, Hayashi S, Miyaki T, Itoh M. Left testicular artery arching over the ipsilateral renal vein. Asian J Androl. 2006;8(1):107-10. http://dx.doi.org/10.1111/j.1745-7262.2006.00101.x. PMid:16372128.

19 Lelli F, Maurelli V, Maranillo E, Valderrama-Canales FJ. Arched and retrocaval testicular arteries: a case report. Eur J Anat. 2007;11:119-22.

20 Pai MM, Vadgaonkar R, Rai R, et al. A cadaveric study of the testicular artery in the South Indian population. Singapore Med J. 2008;49(7):551-5. PMid:18695863.

21 Wadhwa A, Soni S. A study of Gonadal Arteries in 30 adult human cadavers. Clin Med Insights Reprod Heal. 2010;4:1-5. https://doi.org/10.4137/CMRH.S3680.

22 Mamatha Y, Prakash BS, Padma Latha K, Ramesh BR. Variant course of left gonadal artery. Int J Anat Var. 2010;3:132-3.

23 Grine FE, Kramer B. Arched gonadal arteries in the South African negro. J Anat. 1981;132(Pt 3):387-90. PMid:7298490.

24 Li J. A retrocaval right testicular artery with an arching left testicular artery. Eur J Anat. 2015;19:85-6.
 


Submitted date:
08/23/2023

Accepted date:
11/30/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
65ccc20ea953954f4e2eacf4 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections