Anomalous Renal Vasculature Existing With Congenital Anomalies of Kidneys, Ureters and Suprarenal Glands: A Cadaveric Study

Abstract

Variations in the renal vessels have been observed frequently in routine dissection and surgical practice, but existing with congenital anomalies of kidneys or ureters or suprarenal glands is very rare. Accordingly the aim of this study was designed to evaluate the prevalence of anomalous renal vasculature existing with congenital anomalies of kidneys, ureters and suprarenal glands. This study was carried out on 48 human cadavers (including dissected cadaveric specimens) irrespective of age and sex used for routine dissection of abdomen conducted for medical undergraduates teaching purpose. The kidneys, ureters and suprarenal glands along with their arteries were exposed and the anomalous variations of renal vasculature existing with congenital anomalies of kidneys or ureters or suprarenal glands were observed. Photographs of the anomalous and developmental variations were taken for proper documentation. Out of 48 human cadavers following anomalous / developmental variations were noted- unilateral retro aortic left real vein, extra-hilar artery (branch of renal artery that presents an extra hilar penetration) to the superior pole of left kidney, existing with very rare and unusual double suprarenal gland with unusual blood supply was noted in one cadaver. Bilateral double renal arteries existing with unusual incomplete double ureters on right side and incomplete triple ureters on left side were found in one cadaver. Left triple renal arteries, right double renal arteries existing with bilateral polycystic kidneys with distended ureters were found in one cadaver. Double extra-hilar arteries to the superior pole of right kidney, existing with unusual blood supply to the right suprarenal gland and right testis was found in one cadaver. Bilateral Early division of renal artery existing with bilateral polycystic kidneys fond in one cadaver. Anatomical and developmental variations of renal vasculature, ureters, kidneys and their relationship to surrounding structures  are clinically significant as they interferes several operative procedures like kidney transplantation, surgical reconstruction of the abdominal aorta, interventional radiologic procedures and urologic operations; hence detection of the possible developmental variations of the renal vasculature, ureters, kidneys and their relationship to surrounding structures is clinically necessary for adequate surgical management to preserve renal functions.