Anat Cell Biol.  2012 Dec;45(4):282-284. 10.5115/acb.2012.45.4.282.

The double retro-aortic left renal vein

• Kyung DS
• Lee JH
• Shin DY
• Kim DK
• Choi IJ

• KMID: 2133914
• DOI: http://doi.org/10.5115/acb.2012.45.4.282

Abstract

The renal veins drain the kidney into the inferior vena cava and unite in a variable fashion to form the renal vein. The left renal vein is normally located in front of the aorta. However, the retro-aortic renal vein may course posterior to the aorta due to embryological developmental anomalies. During educational dissection, a rare variation of the left renal vein was found in a 66-year old male cadaver. The double retro-aortic renal veins coursed behind the aorta to drain into the inferior vena cava. The superior retro-aortic renal vein drained into the inferior vena cava at the lower border of the L2 vertebra, and the inferior retro-aortic renal vein drained into the inferior vena cava at the upper border of the L4 vertebra. Such a variant is rare, and is a clinically important observation which should be noted by vascular surgeons, oncologists, and traumatologists.

Keyword

Renal veins; Variation; Retro-aortic

MeSH Terms

Aorta
Cadaver
Humans
Kidney
Male
Renal Veins
Spine
Vena Cava, Inferior

Figure

• 

  Fig. 1 Photograph (A) and schematic drawing (B) showing double retro-aortic left renal vein. Two retro-aortic left renal veins (SRA-LRV and IRA-LRV) were drained into inferior vena cava. Ao, aorta; IRA-LRV, inferior retro-aortic left renal vein; IVC, inferior vena cava; LRA, left renal artery; LSV, left suprarenal vein; LTA, left testicular artery; LTV, left testicular vein; RRA, right renal artery; SRA-LRV, superior retro-aortic left renal vein; U, ureter.

• 

  Fig. 2 Drawing of the development of the renal vein. (A) Renal venous collar at 8 week of embryogenesis. (B) Normal development of renal veins in adult. (C) Abnormal development of renal vein in present report. A, aorta; d.RV, dorsal renal vein; IsC-a, intersubcardinal anastomosis; ISC-a, intersupracardinal anastomosis; sCV, subcardinal vein; SCV, supracardinal vein; sSC-a, subsupracardinal anastomosis; v.RV, ventral renal vein.

Reference

1. Arslan H, Etlik O, Ceylan K, Temizoz O, Harman M, Kavan M. Incidence of retro-aortic left renal vein and its relationship with varicocele. Eur Radiol. 2005. 15:1717–1720.

2. Hoeltl W, Hruby W, Aharinejad S. Renal vein anatomy and its implications for retroperitoneal surgery. J Urol. 1990. 143:1108–1114.

3. Karazincir S, Balci A, Görür S, Sumbas H, Kiper AN. Incidence of the retroaortic left renal vein in patients with varicocele. J Ultrasound Med. 2007. 26:601–604.

4. Martinez-Almagro A, Almenar Garcia V, Martinez Sanjuan V, Hernandez Gil de Tejada T, Lorente Montalvo P. Retroaortic left renal vein: a report of six cases. Surg Radiol Anat. 1992. 14:361–366.

5. Reed MD, Friedman AC, Nealey P. Anomalies of the left renal vein: analysis of 433 CT scans. J Comput Assist Tomogr. 1982. 6:1124–1126.

6. Trigaux JP, Vandroogenbroek S, De Wispelaere JF, Lacrosse M, Jamart J. Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT. J Vasc Interv Radiol. 1998. 9:339–345.

7. Senecail B, Bobeuf J, Forlodou P, Nonent M. Two rare anomalies of the left renal vein. Surg Radiol Anat. 2003. 25:465–467.

8. Nam JK, Park SW, Lee SD, Chung MK. The clinical significance of a retroaortic left renal vein. Korean J Urol. 2010. 51:276–280.

9. Koc Z, Ulusan S, Tokmak N, Oguzkurt L, Yildirim T. Double retroaortic left renal veins as a possible cause of pelvic congestion syndrome: imaging findings in two patients. Br J Radiol. 2006. 79:e152–e155.

10. Anjamrooz SH, Azari H, Abedinzadeh M. Abnormal patterns of the renal veins. Anat Cell Biol. 2012. 45:57–61.