IJCRR - 6(15), August, 2014
Pages: 57-59
Date of Publication: 10-Aug-2014
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VARIATION IN THE COURSE OF RIGHT RENAL ARTERY- A CADAVERIC STUDY
Author: Pradnya Kulkarni, Pradeep Pilajirao Kulkarni
Category:
Abstract:Objectives: Recognize the common variations of renal vascular anatomy to avoid bleeding during transplantation and other surgeries related to kidney. Method: During dissection we found the variation in the course of right and left renal artery. On the right side renal artery was turning around the renal vein, coming anterior to the vein. While coming anteriorly it was giving segmental branches. Result: The organs which make extensive migrations during growth may either retain vessels from their original location (as in testis), or receive and incorporate new vessels of the region invaded (as in thyroid gland). Conclusion: Surgeon should know about blood vessels near kidney before doing any surgery related to kidney, especially in
transplantation surgery.
Keywords: Renal vascular anatomy, transplantation
Full Text:
INTRODUCTION
Knowledge of the number, size, course, and relationship of the renal arteries (of donor and recipient) are essential for the renal transplant. To avoid bleeding, knowledge of renal artery, its branches and their variations is important for any vascular reconstruction, endoscopic surgeries, treatment of abdominal aortic aneurism and treatment of renal artery stenosis and clinical evaluation of hypertension. In the present study, we highlight the abnormal course of renal artery.
Normal Renal Vascular Anatomy
In most individuals, each kidney is supplied by a single renal artery that originates from the abdominal aorta. The renal arteries typically arise from the aorta at the level of L2 below the origin of the superior mesenteric artery, with the renal vein being anterior to the renal artery. The renal arteries course anterior to the renal pelvis before they enter the medial aspect of the renal hilum. The right renal artery is longer (as abdominal aorta is slightly to the left of the midline) and usually arises slightly higher than the left.1 The main renal artery divides into segmental arteries near the renal hilum (Fig.1and 2). The first division is typically the posterior branch, which arises just before the renal hilum and passes posterior to the renal pelvis. The main renal artery then continues before dividing into four anterior branches at the renal hilum: the apical, upper, middle, and lower anterior segmental arteries. The apical and lower anterior segmental arteries supply the anterior and posterior surfaces of the upper and lower renal poles, respectively; the upper and middle segmental arteries supply the remainder of the anterior surface.
Embryology
1. The embryological explanation of these variations has been presented and discussed by Keibel F and Mall FP2 . In an 18 mm fetus, the developing mesonephros, metanephros, suprarenal glands and gonads are supplied by nine pairs of lateral mesonephric arteries arising from the dorsal aorta. Felix divided these arteries into three groups as follows: the 1st and 2nd arteries as the cranial group, the 3rd to 5th arteries as the middle group and 6th to 9th arteries as the caudal group.
References:
1. Grey’s Anatomy, 40th edition, section 8, chapter 62, page 1074
2. [KEIBEL F, MALL FP (eds), Manual of human embryology,Vol. 2, J.B. Lippincott, Philadelphia, 1912, 820–825]
3. Grey’s Anatomy, 40th edition, section 2, chapter 13, page 206- 207
4. (Human Embryology and Teratology by Ronan o’Rahilly and Fabiola Muller, 3rd edition, chapter 15, page 303-304).
5. (Essentials of Human Embryology by William J. Larsen, Chapter 8, page 131-132)
6. (Human Embryology and Teratology by Ronan o’Rahilly and Fabiola Muller, 3rd edition, chapter 15, page 308).
7. Bremer, J. L. (1915), the origin of the renal artery in mammals and its anomalies. Am. J. Anat., 18: 179–200. doi: 10.1002/ aja.1000180203)
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