Korean J Urol.  2010 Apr;51(4):276-280.

The Clinical Significance of a Retroaortic Left Renal Vein

• Nam JK
• Park SW
• Lee SD
• Chung MK

Abstract

PURPOSE
A retroaortic left renal vein (RLRV) is located between the aorta and the vertebra and drains into the inferior vena cava. Urological symptoms can be caused by increased pressure in the renal vein. To evaluate the clinical importance of RLRV, we reviewed patients' medical records and radiologic findings. MATERIALS AND METHODS: Nine patients who were studied with multidetector computed tomography at our institution from January 2003 to December 2009 had urologic symptoms with RLRV. We retrospectively reviewed these patients' medical records and analyzed their clinical characteristics. RESULTS: The patients' mean age was 46.0+/-20.1 years (range, 17-65 years) and the male to female ratio was 5 to 4. The urologic symptoms of the initial diagnosis were various (hematuria: 5 of the 9 patients; left flank pain: 4 of the 9 patients; inguinal pain: 1 of the 5 male patients; and gross hematuria: 1 of the 9 patients). The distribution among the type I, II, III, and IV of RLRV was 6, 2, 1, and 0 patients, respectively. The concomitant diseases were ureteropelvic junction obstruction (UPJO; 2 of the 9 patients) and varicocele (2 of the 5 male patients). One patient with UPJO underwent pyeloplasty and the other patient with UPJO underwent nephrectomy due to a nonfunctional atrophied kidney. The microscopic hematuria was not resolved with conservative management for long-term follow-up. CONCLUSIONS: Hematuria and inguinal or flank pain seem to be common in patients with RLRV. The most common type of RLRV was type I. It appeared that the microscopic hematuria continued in the long-term follow-up.

Keyword

Abnormalities; Renal veins; Tomography

MeSH Terms

Aorta
Female
Flank Pain
Follow-Up Studies
Hematuria
Humans
Kidney
Male
Medical Records
Multidetector Computed Tomography
Nephrectomy
Renal Veins
Retrospective Studies
Spine
Varicocele
Vena Cava, Inferior

Figure

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  FIG. 1 Schematic illustration of the different types of retroaortic left renal vein anomalies. (A) type I, (B) type II, (C) type III, (D) type IV.

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  FIG. 2 Type I, II, and III of RLRV. (A) Type I of RLRV (arrow). (B) Type III of RLRV. The superior left renal vein (open arrow) and inferior left renal vein (arrow) crossed anterior and posterior to the aorta. (C, D) Ureteropelvic junction obstruction with type II of RLRV. Anteromedial crossing vessel (arrow in C) and joining IVC (arrow in D) at level L4. RLRV: retroaortic left renal vein, IVC: inferior vena cava.

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