Accessory renal arteries and associated variations in the arrangement of structures at the hilum of the kidney – a cadaveric study

The present study was done in the department of Anatomy at Government Medical College Srinagar to study the variationsin the arrangement of structures at the hilum of kidney and their clinical Significance.30 kidneys (n:2) from 15(n:1) formalin preserved cadavers were taken for this study and anatomical variations of renal arteries and arrangement of structures at the hilum of each kidney was studied. It was observed that in one of the cadavers with supernumerary renal arteries arrangement of structures in the hilum of right kidney was arteries, vein and renal pelvis from anterior to posterior in contrast to the usual arrangement of vein, artery and renal pelvis. In this cadaver we found that renal right renal artery after originating from abdominal aorta at the level of first Lumbar vertebra divided into three branches. The superior branch (S) entered the upper pole of kidney, middle (M) and inferior branch (I) made their entry through the hilum but anterior to renal Vein. The inferior suprarenal artery (ISA) originated from superior the superior branch common renal artery (S). The origin and course and branching pattern of renal vessels on the left side of this cadaver was normal. In this series we do not found any accessory renal artery originating from coeliac trunk, superior mesenteric artery or common iliac artery. Though anomalies of renal artery are very common but usually the arrangement of structures at the hilum remains unchanged. The knowledge of this rare anomaly with change in pattern of structures at the renal hilum is very useful in Interventional Radiology/ Cardiology, planning laparoscopic renal transplants and urological surgeries with better prognosis.