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Tuesday, 24 April 2012

Accessory renal artery







Left kidney with twin accessory renal arteries



During the routine dissection hours a cadaver displayed a left kidney supplied by two accessory renal arteries which branched out from the aorta and had a sinuous course.  The main renal artery (MRA) was seen  entering into the hilum behind the main renal vein(MRV) .

The first accessory renal artery(ARA-1)  branched from the left lateral side of the aorta just above the level  of superior mesenteric artery.

It was running laterally showing a kink almost in the centre of its course. It entered into the  kidney through the anterior substance of the kidney just above the hilum.

A  segmental branch was seen entering the hilum lying anterior to the main renal vein.

The 2nd accessory renal artery(ARA-2) was seen arising about 5.7 cms below the origin of superior mesenteric artery(SMA) .  It is longer than the 1st accessory renal artery  extending laterally from the aorta it is seen entering into the left kidney just below the renal pelvis. A gonadal branch was seen branching out . The left gonadal vein( LGV) is seen draining into the left renal vein .

The hilum was extending over to the anterior surface of the kidney and crowding of the vascular structures was seen . However the pelvis remained most posterior .

Clinical significance

Presence of such twin renal arteries can complicate the interpretation of renal angiograms and challenge the urologists performing laparoscopic and renal transplantation procedures   

Acknowledgements:

Special thanks to  Manisha , swatika, Atif , kareem and Shahzeb zaman.( MBBS students of 2010-11 batch Shadan Medical College . Hyderabad . India)


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