Variations in renal arteries and pelvicalyceal system: A case report

Abstract

To describe a complex case of anomalous kidneys involving right early division of renal artery, left accessory renal artery, bilateral upper polar arteries and bilateral extrarenal calyces. This is a very rare case documented having these four anomalies together. The variations were observed during routine anatomical dissection in a male cadaver at department of anatomy, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, IndiaDuring dissection, multiple anatomical variations involving the structures at the hilum of right kidney were found. Right kidney showed early division of renal artery (RRA) 1.4 cm close to aorta. Left kidney showed accessory renal artery (LARA) 5 mm above origin of main renal artery (LRA), running obliquely entering the hilum. Two polar arteries were seen entering upper pole on right kidney as well as left kidney (RUPA1, RUPA2, LUPA1, LUPA2). Extrarenal calyces were observed to be present in both the kidneys, two on the right and three on the left. The variations observed are of importance as multiple anomalies are present in a single cadaver. They are of significance during surgical procedures like renal transplantation, aortic surgeries and in radiological interpretation.