Bilateral lateral rotation of the kidneys with their hilum facing laterally (outwards) - Rare anatomical variations

Among the variations of the renal system, abnormalities of structure and position of kidney along with the variations of renal vessels are reported most frequently. However, reports on rotational abnormalities and abnormal positions of renal hilum are scanty. During routine dissection of the posterior abdominal wall, laterally rotated kidneys with laterally facing hila were observed in about 60-year-old male cadaver. On right side, the hilum was more on the anterior surface of the organ and right renal vein was emerging almost from the middle of the anterior surface at the lateral edge of the hilum. However, the hilum of the left kidney was observed along the lateral border of the organ and left renal artery was crossing transversely anterior to the kidney forming a loop to reach the hilum. It was also observed that because of the lateral position of the hilum, the renal vessels and pelvis where passing over the anterior surface of the kidney. Rotational variations and abnormal locations of renal hilum are of importance in surgical procedures like percutaneous nephrectomy. Further clinical and surgical importance of the case is discussed in the paper.DOI: http://dx.doi.org/10.3126/ajms.v6i5.12414 Asian Journal of Medical Sciences Vol.6(5) 2015 82-84

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RETRO-AORTIC LEFT RENAL VEIN WITH DOUBLE LEFT RENAL ARTERY: A CASE REPORT

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703749 ◽

2014 ◽

Vol 04 (01) ◽

pp. 126-128

Author(s):

Vishal K. ◽

Vinay K. V. ◽

Remya K. ◽

Keyword(s):

Renal Vein ◽

Left Renal Vein ◽

Left Kidney ◽

Lumbar Vertebrae ◽

Renal Arteries ◽

Left Renal Artery ◽

Renal Vessels ◽

Male Cadaver ◽

Radiological Procedures ◽

Excretory Organs

Abstract:The kidneys are the excretory organs. The kidneys are supplied by right and left renal arteries at the level of second lumbar vertebrae. They are drained by right and left renal vein which runs anterior to renal arteries.During routine dissection of an adult male cadaver in the department of Anatomy, we observed an unusual variation in the blood vessels supplying left kidney.These variations are due to persistence of embryonic vessels.Though variations in the renal vessels are common, proper knowledge of variations is essential not only to the anatomists but also for the clinicians and to perform surgical and radiological procedures more safely and efficiently.

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Bilateral Vascular Variations at the Renal Hilum: A Case Report

Case Reports in Vascular Medicine ◽

10.1155/2012/968506 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

Naveen Kumar ◽

Ashwini P. Aithal ◽

Anitha Guru ◽

Satheesha B. Nayak

Keyword(s):

Renal Artery ◽

Left Kidney ◽

Left Renal Artery ◽

Anterior Branch ◽

Precise Knowledge ◽

Renal Vessels ◽

Renal Hilum ◽

Aberrant Artery ◽

Vascular Structures ◽

The Right

Imaging technology with its advancement in the field of urology is the boon for the patients who require minimally invasive approaches for various kidney disorders. These approaches require a precise knowledge of the normal and variant anatomy of vascular structures at the hilum of the kidney in terms of their pattern of arrangement and division. The present paper describes a bilateral anomalous arrangement of the structures at the renal hilum as well as their peculiar branching pattern which is of clinical and surgical relevance. Multiple branching of the renal vessels was observed in both kidneys due to which the hila were congested. The right renal artery immediately after its origin divided into 2 branches. The upper branch represented an aberrant artery whereas the lower branch gave 5 divisions. The left renal artery also divided into 2 branches much before the hilum as anterior and posterior divisions. The anterior branch took an arched course and gave 6 branches. The posterior branch gave 3 terminal branches before entering the renal substance. In addition to anomalous hilar structures, normal architecture of both kidneys was altered and the hilum of the left kidney was found on its anterior surface.

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A Unique Case of Incomplete Bifid Ureter and Associated Arterial Variations

Case Reports in Urology ◽

10.1155/2021/6655813 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Shivika Ahuja ◽

Hannah Sullivan ◽

Mark Noller ◽

Yun Tan ◽

Daniel Daly

Keyword(s):

Renal Artery ◽

Imaging Techniques ◽

Left Kidney ◽

Anatomical Variations ◽

Left Renal Artery ◽

Renal Vasculature ◽

Duplex Kidney ◽

Ovarian Artery ◽

Psoas Major Muscle ◽

Bifid Ureter

Introduction. Urogenital and vascular anomalies, including a left duplex kidney and a left aberrant renal artery that gave rise to the left ovarian artery, were observed in a 77-year-old female cadaver during a routine dissection. Description. A left aberrant renal artery, which gave rise to the left ovarian artery, was observed originating from the aorta 4 cm below the left renal artery. Two independent contributions to a bifid ureter were found originating from the hilum of the left kidney. These two contributions descended 12.4 cm and 10.6 cm, respectively, posterior to the left aberrant renal artery and lateral to the left ovarian artery before uniting anterior to the psoas major muscle to descend 12.7 cm to the bladder. Significance. While the duplex kidney is a relatively common congenital anomaly that can be asymptomatic, it can also potentially be associated with compression of renal vasculature or the ureter. Ureteral compression can then result in several pathologies including reflux, urinary tract infection (UTI), ureteropelvic junction obstruction, or hydronephrosis. Compression of renal and ovarian vasculature can result in altered blood flow to the kidney and ovary, potentially causing fibrosis, atrophy, or organ failure. Current imaging techniques alone are insufficient for correct diagnostics of such complications, and they must be supplemented with a thorough understanding of the respective anatomical variations.

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Bilateral accessory renal arteries in a fetus: importance for surgical and radiological practice

International Journal of Basic and Applied Sciences ◽

10.14419/ijbas.v4i3.4702 ◽

2015 ◽

Vol 4 (3) ◽

pp. 288

Author(s):

José Aderval Aragão ◽

Danillo Primo Andrade Santana ◽

Ellen Caroline da Conceição Brandão ◽

Viviane Freitas Andrade ◽

Marianna Ribeiro de Menezes Freire ◽

...

Keyword(s):

Kidney Transplantation ◽

Renal Artery ◽

Anatomical Variations ◽

Vascular Reconstruction ◽

Renal Arteries ◽

Left Renal Artery ◽

Multiple Renal Arteries ◽

Renal Vessels ◽

The Right ◽

Accessory Renal Arteries

Context: Knowledge of anatomical variations of the renal vessels is considered important, in view of the increasing use of kidney transplantation, vascular reconstruction and imaging methods.Objective: To report on a case of triple right renal artery, and double left renal artery and its clinical-surgical implications.Case report: In a female fetal cadaver of age 30 weeks, multiple renal arteries were observed: triple in the right and double in the left renal artery. All the arteries were hilar and originated from the lateral face of the abdominal aorta. The lengths of the triple renal arteries were 17, 10 and 12 mm respectively for the upper, middle and lower arteries. The lengths of the double arteries were 10 and 12 mm respectively for the upper and lower arteries. There was no extrarenal segmentation.Conclusion: Knowledge of possible variations in the renal arteries may be very useful for radiologists, urologists and vascular surgeons.

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Effects of renovascular hypertension on rat adrenal zona glomerulosa

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100083783 ◽

1978 ◽

Vol 36 (2) ◽

pp. 582-583

Author(s):

G. Mazzocchi ◽

P. Rebuffat ◽

C. Robba ◽

P. Vassanelli ◽

G. G. Nussdorfer

Keyword(s):

Renovascular Hypertension ◽

Left Kidney ◽

Renin Angiotensin System ◽

Plasma Renin ◽

Zona Glomerulosa ◽

Ultrastructural Changes ◽

Albino Rats ◽

Left Renal Artery ◽

Angiotensin System ◽

And Control

It is well known that the rat adrenal zona glomerulosa steroidogenic activity is controlled by the renin-angiotensin system. The ultrastructural changes in the rat zona glomerulosa cells induced by renovascular hypertension were described previously, but as far as we are aware no correlated biochemical and morphometric investigations were performed.Twenty adult male albino rats were divided into 2 experimental groups. One group was subjected to restriction of blood flow to the left kidney by the application of a silver clip about the left renal artery. The other group was sham-operated and served as a control. Renovascular hypertension developed in about 10 days: sistolic blood pressure averaged 165 ± 6. 4 mmHg, whereas it was about 110 ± 3. 8 mmHg in the control animals. The hypertensive and control rats were sacrificed 20 days after the operation. The blood was collected and plasma renin activity was determined by radioimmunological methods. The aldosterone concentration was radioimmunologically assayed both in the plasma and in the homogenate of the left capsular adrenal gland.

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A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v6i4.6727 ◽

2012 ◽

Vol 6 (4) ◽

pp. 49-52

Author(s):

N Satyanarayana ◽

R Guha ◽

P Sunitha ◽

GN Reddy ◽

G Praveen ◽

...

Keyword(s):

Case Report ◽

Brachial Plexus ◽

Upper Limb ◽

Clinical Importance ◽

Medical Sciences ◽

Nerve Roots ◽

Rare Variation ◽

Lower Trunk ◽

Male Cadaver ◽

The Right

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

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Laparoscopic transposition for crossing vessels (vascular hitch) in pure extrinsic pelvic-ureteric junction obstruction: a successful case report of a 2-year-old infant with horseshoe kidney

Surgical Case Reports ◽

10.1186/s40792-021-01190-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Satoshi Ieiri ◽

Kouji Nagata

Keyword(s):

Laparoscopic Surgery ◽

Left Kidney ◽

Horseshoe Kidney ◽

Renal Scintigraphy ◽

Multicystic Dysplastic Kidney ◽

Extrinsic Compression ◽

Dysplastic Kidney ◽

Renal Vessels ◽

The Right ◽

Crossing Vessels

Abstract Background Pediatric hydronephrosis induced by pelvic-ureteric junction obstruction (PUJO) is treated by dismembered pyeloplasty (DP) via open and laparoscopic surgery. The etiology of PUJO involves both intrinsic stenosis and extrinsic compression of crossing vessels (CVs). PUJO owing to CVs is also treated by DP, as there is no consensus concerning this vascular condition. We encountered a 2-year-old infant with pure extrinsic PUJO combined with horseshoe kidney who successfully underwent laparoscopic transposition for CVs (vascular hitch). Case presentation A 2-year-old boy was prenatally diagnosed with left multicystic dysplastic kidney (MDCK) and right hydronephrosis and received a definitive diagnosis after birth. At 6 months old, renal scintigraphy revealed a non-functioning pattern in the left kidney and an obstructive pattern in the right, showing no response to furosemide loading. The patient also had recurrent urinary tract infection, and his right hydronephrosis gradually worsened. We decided to perform surgery for the right PUJO. Preoperative enhanced computed tomography detected three right renal vessels independently branching from the abdominal aorta. The middle renal vessels were located at the ventral side of the pelvis and coincident with the site of PUJO. These vessels were suspected of being CVs. The patient underwent laparoscopic surgery electively. A 5-mm trocar was inserted at the umbilicus for a 5-mm, 30° rigid scope. Two additional ports were then inserted under laparoscope inspection. The dilated right pelvis and CVs were detected after ascending colon mobilization. To confirm the pathogenesis of PUJO, the CVs were dissected and taped. After taping the CVs, an intraoperative diuretic test was performed using furosemide loading. Peristalsis of the right ureter was recognized, and the extrinsic PUJO owing to the CVs was definitively confirmed. We therefore performed transposition for the CVs (vascular hitch procedure). The CVs were mobilized in the cranial direction and those were wrapped by dilated pelvis. The post-operative course was uneventful. The renal scintigraphy findings improved and showed a favorable response of furosemide loading. Conclusions The laparoscopic vascular hitch procedure is minimally invasive and effective for extrinsic PUJO due to CVs. Anastomotic stricture after Anderson and Hynes DP can be prevented by appropriate patient selection.

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PERFORATION OF INFERIOR ALVEOLAR NERVE BY MAXILLARY ARTERY. Perforation of inferior alveolar nerve by maxillary artery

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v3.n3.13935 ◽

2016 ◽

Vol 3 (3) ◽

pp. 124-129

Author(s):

Prakash B Billakanti

Keyword(s):

Infratemporal Fossa ◽

Maxillofacial Surgery ◽

Inferior Alveolar Nerve ◽

Anatomical Variations ◽

Clinical Implications ◽

Maxillary Artery ◽

Foramen Ovale ◽

Anesthetic Agents ◽

Male Cadaver ◽

Anatomical Area

La fosa infratemporal es un área anatómica clínicamente importante para la administración de agentes anestésicos locales en odontología y cirugía maxilofacial. Fueron estudiadas variaciones en la anatomía del nervio alveolar inferior y la arteria maxilar en la disección infratemporal. Durante la disección rutinaria de la cabeza en el cadáver de un varón adulto, fue observada una variación excepcional en el origen del nervio alveolar inferior y su relación con las estructuras circundantes. El nervio alveolar inferior se originaba en el nervio mandibular por dos raíces y la primera parte de la arteria maxilar estaba incorporada entre ambas. El origen embriológico de esta variación y sus implicaciones clínicas es debatido. Dado que la arteria maxilar transcurría entre las dos raíces del nervio alveolar inferior, y el nervio estaba fijado entre el foramen oval y el foramen mandibular, el atrapamiento vásculo-nervioso pudo causar entume-cimiento o dolor de cabeza e interferir con la inyección de anestésicos locales en la fosa infratemporal. Variaciones anatómicas en esta región deben ser tenidas en cuenta, especialmente en casos de tratamiento fallido de neuralgia del trigémino. Infratemporal fossa is clinically important anatomical area for the delivery of local anesthetic agents in dentistry and maxillofacial surgery. Variations in the anatomy of the inferior alveolar nerve and maxillary artery were studied in infratemporal dissection. During routine dissection of the head in an adult male cadaver an unusual variation in the origin of the inferior alveolar nerve and its relationship with the surrounding structures was observed. The inferior alveolar nerve originated from the mandibular nerve by two roots and the first part of the maxillary artery was incorporated between them. An embryologic origin of this variation and its clinical implications is discussed. Because the maxillary artery runs between the two roots of the inferior alveolar nerve, and the nerve was fixed between the foramen ovale and mandibular foramen, neurovascular entrapment may cause pain numbness or headache and may interfere with the injection of local anesthetics into the infratemporal fossa. Anatomical variations in this region should be kept in mind, particularly in cases of failed treatment of trigeminal neuralgia.

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Persistent left superior vena cava and its clinical correlation - A cadaveric study

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i4.33321 ◽

2021 ◽

Vol 12 (4) ◽

pp. 118-121

Author(s):

Sachendra Kumar Mittal ◽

Rekha Parashar ◽

Pankaj Kumar Singh ◽

Leena Jadon

Keyword(s):

Superior Vena Cava ◽

Right Atrium ◽

Superior Vena ◽

Vena Cava ◽

Medical Sciences ◽

Left Superior Vena Cava ◽

Persistent Left Superior Vena ◽

Male Cadaver ◽

The Right ◽

Brachiocephalic Veins

Background: Presented is a case of persistent left superior vena cava draining into the right atrium through coronary sinus and finally opens into right atrium. Abnormalities of the vascular system are more commonly seen due to its importance in circulation. Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress.The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachiocephalic veins which are in turn formed by the union of internal jugular and subclavian veins of corresponding side, draining the head and neck as well as the superior extremity. Aims and Objective: To evaluate the accuracy of persistent left superior vena cava and to find out the opening of PLSVC and formations of both SVC. Materials and Methods: During routine dissection of Thorax, we have opened the thoracic cage and take out the Heart. during that we found separate SVC and then we did the study on this PLSVC in the Department of Anatomy, Jaipur National University Institute for Medical Sciences and Research Centre (JNUIMSRC) Jaipur and National Institute of Medical Sciences and Research (NIMS & R). Results: We found persistent left superior vena cava in two cadavers out of 30 cadavers (6.66%) one was 64-year-old male cadaver and another 72-year-old male cadaver. Both the vena cavae were formed as of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior vena cava and right atrio-ventricular orifice. Conclusion: It has important clinical implications in certain clinical interventions. It may complicate placementof cardiac catheters or pacemaker leads.

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Results of a three-year follow-up after endovascular therapy with multilayer flow modulator in complex thoracoabdominal aortic aneurysm: A case report

Vascular ◽

10.1177/1708538120933516 ◽

2020 ◽

pp. 170853812093351

Author(s):

Nazım Kankılıç ◽

Mehmet S Aydın

Keyword(s):

Case Report ◽

Aortic Aneurysm ◽

Renal Artery ◽

Medical Center ◽

Left Kidney ◽

Thoracoabdominal Aortic Aneurysm ◽

Aortic Aneurysms ◽

Left Renal Artery

Objectives Studies on the short-, medium and long-term effects of flow guiding stents are still limited. In this case report, we present three-year follow-up of the multilayer flow modulator stent in a 55-year-old patient with Crawford Type 2 thoracoabdominal aortic aneurysm. Methods A 55-year-old male patient with Crawford Type 2 thoracoabdominal aortic aneurysm had applied to our medical center. The aneurysm involved coeliac truncus and superior mesenteric artery and extended to the renal artery ostia. Multilayer flow modulator stent was successfully placed, and follow-up CT (Computed tomography) angiographic examination images recorded intermittently (36 months). Results After three years, it was observed that the left renal artery was thrombosed and the left kidney went to atrophy. Other major vascular branches were observed to be open. During this time, the aneurysm was completely closed with thrombus, but the diameter of the aneurysm continued to increase. Conclusions Multilayer flow modulator stents are safe in complex aortic aneurysms. The device increases the thrombus load in the aortic aneurysm and maintains the flow of the main vascular branches. But re-interventions, dilatation of the aneurysm sac and visceral branch obstructions are still challenging for multilayer flow modulator stents.

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