doubled right renal vein - a case...

AAMJ / Vol. 3 / Issue 3 / May – June 2017

A A M J Anveshana Ayurveda Medical Journal

www.aamj.in ISSN: 2395-4159

Case Report

Doubled Right Renal Vein - A Case Study

Rajani Mise 1 Debasis Kundu 2 Arup Ratan Das 3

A b s t r a c t

Kidneys is one of the most vital functions of the circulatory system. Despite their relatively small

size, the kidneys receive about 20% of the heart’s blood output for filtration. In the abdomen,

the renal arteries branch from the abdominal aorta inferior to the superior mesenteric artery and

extend laterally toward the kidneys. Just before reaching the kidney, each renal artery divides

into five segmental arteries, which provide blood to the various regions of the kidney. Each

segmental artery enters the hilum of the kidney and divides into several inter-lobar arteries,

which pass through the renal columns between the renal pyramids and carry blood toward the

exterior of the kidney. At the junction between the renal cortex and renal medulla, the interlobar

arteries form the arcuate arteries, which turn to follow the contours of the renal pyramids. From

the arcuate arteries several branches, known as interlobular arteries, separate at right angles

and extend through the renal cortex toward the exterior of the kidney. Each interlobular artery

forms several afferent arterioles, which end in a bed of capillaries known as glomeruli where

blood is filtered to form urine.

This study includes the presence of a renal vein on right side draining into the inferior vena

cava. This variation was observed during routine dissection of a male cadaver middle aged.

This variation is of important because of its implication in renal transplantation, renal surgery,

vascular surgery. The knowledge of such variation can help the clinician for its recognition and

protection.

Keywords: Anatomical variation, Renal veins, Inferior vena cava, Kidney transplantation.

1 PG Scholar, Dept of Shareer rachana, N K Jabshetty Ayurvedic Medical College and Hospital

and P G Centre, Bidar.

CORRESPONDING AUTHOR

Dr. Rajani Mise

PG Scholar,

Department of Shareer rachana,

N K Jabshetty Ayurvedic Medical College and Hospital and P G Centre,

Bidar, Karnataka. (India).

Email: [email protected]

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Rajani et.al,. : Doubled Right Renal Vein - A Case Study

AAMJ / Vol. 3 / Issue 3 / May – June 2017 1299

INTRODUCTION

idneys are a pair of excretory organs situated on

the posterior abdominal wall, one on each side of

the vertebral column, behind the peritoneum. They

remove waste products of metabolism, excess of water,

salts from the blood, and maintain its Ph [i].

Normally each kidney is supplied by single a renal ves-

sel, that is the kidney are drained by two veins, one right

and one left.[ii]

Fine tributaries from the venous ends of the peritubular

plexuses converge to join interlobular veins, one with

each interlobular artery. Many interlobular veins begin

beneath the fibrous renal capsule by the convergence of

several stellate veins, which drain the most superficial

zone of the renal cortex and so are named from their

surface appearance. Interlobular veins pass to the corti-

comedullary junction and also receive some ascending

vasa recta before ending in arcuate veins (which accom-

pany arcuate arteries), and anastomose with neighbor-

ing veins. Arcuate veins drain into interlobar veins, which

anastomose and form the renal vein.[iii]

The large renal veins lie anterior to the renal arteries and

open into the inferior vena cava almost at right angles.

The left vein is three times longer than the right; hence

the left kidney is preferred site for the live donor.

The right renal vein is behind the descending duodenum

and sometimes the lateral part of the head of the pan-

creas. It can be extremely short (<1 cm) such that safe

nephrectomy may require excision of a cuff of the inferior

vena cava.

Variation in the renal venous pattern is less common as

compared to the arterial pattern. There may be a chance

of second renal vein occurring frequently on the right

side. In the present case we found 2 renal veins on the

right side. Here among 2 renal veins one is drained into

the inferior vena cava laterally but another one drained

into the inferior vena cava posteriorly.

The anatomical vari-

ations are important

to know before per-

forming any diagnos-

tic and interventional

procedures in renal

diseases

Objectives:

To report on a case

of duplication of the

right renal vein and

its clinical and surgi-

cal implications.

K



Case Report:

The renal venous pattern variation was found in middle

aged male cadaver during the routine dissection of ab-

domen in department of rachana (anatomy) in N.K.J.

Ayurvedic medical college. In this case, in right kidney,

two renal veins are seen namely upper and lower, paral-

lel to each other, one vein emerged from the upper por-

tion of the hilum, while the other emerged from the lower

portion of the hilum. Again each single vein is receiving

two venous tributaries.

Upper right renal vein was emerging from upper part of

hilum (kidney) at the level of L1 vertebra passed super-

omedially and then it finally drained into the IVC posteri-

orly.

Lower right renal vein was emerging from lower part of

hilum, crossing anterior to right ureter-pelvic junction,

then drains into the IVC laterally, ultimately the two veins

drained separately into the inferior vena cava.

DISCUSSION

On the basis of many studies it has been accepted that

the more number of variations are present in the renal

vessels, among these variations renal arterial pattern is

more common compared to venous pattern.

Second additional renal veins occurred frequently on the

right side (5%) of cases. Variations of right renal vein are

more common than left. The incident of additional renal

veins reported to be 3.3% on right side and 2% on left

Commonly if the veins are two also they are draining

laterally into the inferior vena cava. But in this cadaver

one is posteriorly drained that is upper one and one more

is laterally drained that is lower one into the inferior vena

cava.

During embryological development the right renal vein is

a mesonephric vein that originally drains into the subcar-

dinal vein. It opens into the part of the vena cava which

is derived from the subcardinal vein.

The left renal vein is derived from –

a. The mesonephric vein that originally drains into the

left subcardinal vein.

b. A small part of left subcardinal vein;

c. The inter subcardinal anastomosis. As this anastomo-

sis is in front of the aorta, the left renal vein has a

similar relation.[iv]

Renal vein with its tributaries

Double Renal Vein



CONCLUSION

1. Two renal veins are drained into inferior vena cava

one is posteriorly and one is laterally.

2. Detailed knowledge of the anatomy and anomalies

and variations of renal veins is necessary for retro-

peritoneal surgeries and venography procedure.

3. These anatomical variations of the renal veins must

be kept in mind to prevent bleeding by an accidental

lesion when operating in the retroperitoneal region.

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REFERENCES

i. B.D. Chaurasia’s; Human anatomy; Fifth edition; Krishna-

garg ;2010.Volume-2; 324p.

ii. H Yekappasuma- retro-aortic left renal vein-an anatomical

variation description and review of literature article.

iii. Gray’s anatomy; The anatomical basis of clinical practice;

Fortieth edition ;Susanstandring; Churchilliving stone;

2008; 1233p.

iv. Inderbir singh G P Pal’s Human embryology; 9th edition;

2012. 240p.

Source of Support: Nil.

Conflict of Interest: None declared

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How to cite this article: Rajani et.al,. : Doubled Right Renal

Vein - A Case Study AAMJ 2017; 3:1298 – 1301

doubled right renal vein - a case...

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