Knowledge of the branching pattern of aortic arch is important during supra-aortic angiography, aortic instrumentation, thoracic and neck surgery. The purpose of this study is to describe different branching pattern of arch of aorta in Indian subjects, in order to offer useful data to anatomists, radiologists, vascular surgeons while relating it to the embryological basis. Seventy five arches of adult Indian cadavers were exposed and their branches examined during cadaveric dissection in the Department of Anatomy, Government Medical College, Nagpur. The usual three-branched aortic arch was found in 58 cadavers (77.3%); the 11 (14.66%) remaining aortic arch showed only two branches, out of which one was a common trunk, which incorporated the brachiocephalic trunk and left common carotid and other left subclavian artery and 6 (8%) aortic arches showed direct arch origin of the left vertebral artery. Although the variations are usually asymptomatic, they may cause dyspnoea, dysphasia, intermittent claudication, misinterpretation of radiological examinations and complications during neck and thorax surgery. Knowledge of different patterns of arch of aorta is critical when invading the arch of aorta and its branches by instruments, as all these areas are delicate.

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Variations of the structure and position of the kidney along with the variations of renal vessels are the most frequently reported. Rotational variations form a rare entity that is not cited in most of the embryology textbooks. During educational cadaveric dissection of a 57-year-old female, a complex picture of bilateral anatomical variants was encountered. Bilateral malrotation of kidney, bilateral lobulated kidneys along with open hilum of kidney was observed, so that the contents of the sinus were exposed. The renal pelvis was present anterior to the renal vessels instead of posterior position.The right kidney in addition showed lower lumbar position with three supplementary arteries and two veins. The right ovarian vein arched over the laterally rotated hilum of kidney and drained into superior renal vein instead of inferior vena cava. This is a rare case in which such numbers of congenital variations are seen. These variations of kidney have embryological base. Rotational variation though comparatively rare assumes great importance in view of the present day surgical procedures like percutaneous nephrectomy, renal transplantation, etc.

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