Triple Right Renal Vein: An Uncommon Variation

Abstract

SUMMARY:We report an unilateral three renal veins the right kidney in an elderly male cadaver. They were three calibrous veins having independent courses up to the inferior vena cava. No other vascular anomalies were noted in this specimen. This anatomical curiosity should be kept in mind by clinicians and academics that may manipulate this anatomical area. KEY WORDS:Anatomy; Anomalies; Human; Kidney; Vein. Case ReportDepartment of Morphology, Biomedical Institute, Fluminense Federal University, RJ, Brazil. 232 DISCUSSIONAnatomical variations and congenital anomalies of the left renal vein were well described by Gillot (1978) and Bergman et al. Sampaio & Aragão reported the variants renal venous drainage.For Gillot and Arey (1941), the three pairs of temporary veins (postcardinals, subcardinals and supracardinals) that form the inferior vena cava and its main tributaries constitute masses of vessels of fleeting duration. There are numerous anastomoses among these three pairs of vessels, the main of which is called renal anastomosis (or renal collar) (Senecail et al., 2003;Gillot).The authors suggest the explanation for this varying pattern based on this step of the embryological development of the right renal vein: There was an error on the fusion of the branches to the dorsal mesonephros derived from the right postcardinal vein, the dorsal-medial branches of the right supracardinal vein and the ventral branches of the right subcardinal vein (the latter represented by the IRRV, marked by the presence of its gonadal tributary (Gillot).The right renal vein is usually a single vessel, formed near the hilum in front of the renal artery (Testut & Latarjet). It describes a horizontal course toward the inferior vena cava, in which it drains. In literature, a significant prevalence of anatomical variations on the left renal vein (about 92%) was found (Baptista-Silva et al., 1997), and the presence of multiple right renal veins (more than 2 vessels) was found in about 8,0 to 9,7% of cases (Baptista-Silva et al.). On the other hand, Bergman et al., pointed that, the renal veins show less variation than do the renal arteries and multiple renal veins to be rare on the left side (1%) and common on the right side (28%). The right renal vein may be doubled, even though the left renal vein is usually single. In our case, we reported a triple right renal vein.Senecail et al., described that the left anomalies of the renal vein may represent real traps in the interpretation of abdominal imaging, particularly in CT scanning, where they are not always recognized, or in magnetic resonance. The abnormal imaging may be the source of technical difficulties in diagnostic or therapeutic angiography (Gillot) and may modify the values obtained by catheter sampling for suprarenal hormonal levels (Satyapal et al., 1999;Senecail et al.).The anatomical knowledge of the renal veins and its variations are of extreme importance for the surgeon that approaches the retroperitoneal region, mainly in face of the current frequency of the renal transpl...

Double right renal vein: clinical and surgical implications and review of the literature

“…An error of fusion of these two vessels, thus causing their persistence, may result in bilateral or unilateral duplication of these vessels [10]. Occurrences of multiple renal veins are relatively common, and several authors have reported large numbers of venous variations resulting from embryonic developmental errors [1], [5], [11][12][13]. According to Kaneko, Kobayashi and Okada [14], the renal veins present fewer variations than do the renal arteries, and multiple renal veins are more common on the right side than on the left-sid [8].…”

A Study of Renal Veins

“…A rare case of three renal veins draining the right kidney and separately joining the inferior vena cava with inferior renal vein receiving right testicular vein was reported earlier [19].…”

Additional right renal veins: clinical implication

“…Fernandes et al [7] suggested the embryological basis for the development of additional right renal vein that there was an error on the fusion of the branches to the dorsal mesonephros derived from the right postcardinal vein, the dorsal -medial branches of the right supracardinal vein and the ventral branches of the right subcardinal vein (the latter represented by the IARV, marked by the presence of its testicular tributary). Bergman et al [3] observed that, the renal veins show less variation than do the renal arteries and multiple renal veins to be rare on the left side (1%) and common on the right side (28%).…”