Unusual Combination Of Vascular Variations In The Retroperitoneal Region. A Morphological Study

Abstract

Background: Blood supply of kidney and gonads is characterized by the presence of variations, which are usually silent and unnoticed until they are found by retroperitoneal surgery, radiologic examination or necropsy. Multiple renal vessels are no longer relative contraindication for laparoscopic donor nephrectomy, however of their presence may help avoid possible complication on a patient with these variations. The purpose of this morphological study was to analyze the frequency of supernumerary renal and testicular vessels and describe an unusual combination of vascular variations in the retroperitoneal region. Methods and Findings:A total of 18 cadavers with different age group and 10 visceral blocks were used for the study in the Morphology Laboratory of the University of Pamplona. Multiple bilateral anatomical variations of testicular and renal vessels were found during routine dissection in a 65-year-old male cadaver. The variations found were: bilateral presence of three renal arteries and three renal veins. The three left renal arteries are divided and gave rise to seven branches: the left main renal artery originates two branches; the upper branch originates four branches and the lower branch originates one branch. Retro-aortic left renal vein. Three left testicular artery and double right testicular artery all originating from accessory renal arteries. Conclusions:Awareness of renal and testicular vessels anomalies is essential for decreasing the rate of accidental injuries in surgical procedures in the retroperitoneal region as well as aid in diagnosis of diseases associated with vascular variation in the posterior abdomen. An understanding of the morphology of renal and testicular vessels is necessary in uroradiology, doppler imaging and computed tomography studies.

A study of evaluation of renal artery measurements using computed tomography angiography in adult Aswanian population

“…The length was measured from the point of origin to the point of the emergence of the first branch. With these results, Arquez 14 and Tarzamni et al 1 found a statistically non-significant differences between the right longer renal artery and the left renal artery. Unlike the present results, Srivastava et al 10 , Saldarriaga et al 13 & Palmieri et al 15 reported a statistically significant difference between the mean length of the right renal artery which was longer than the mean length of the left renal artery.…”

“…Moreover, Saldarriaga et al 13 in a Colombian mestizo population found that the mean diameter of the right renal artery was 4.78 ± 0.86 mm and the mean diameter of the left renal artery was 4.92 ± 0.92 mm, with no significant difference between the right and left renal arterial diameter. Wider diameter of the renal artery was found in the University of Pamplona by Arquez 14 in a cadaveric study who reported that the diameter of the right renal artery found was 6.8±0.16 mm and the diameter of the left renal artery found was 6.9±0.2 mm. By using CT angiography in Brazil, Palmieri et al 15 reported the mean diameter of the right sided renal artery was 6.8 ± 0.16 mm and the left sided renal artery was 6.9 ± 0.2 mm and there was no difference in the comparison between left and right kidneys (p = 0.592).…”