Suprarenal vascular variations should be known to surgeons performing laparoscopic adrenalectomy, partial nephrectomy, living donor nephrectomy and renal transplantation. A rare case of vascular variation of the left suprarenal gland was observed, in which the left suprarenal vein was draining into the inferior vena cava after crossing the abdominal aorta anteriorly, just below the origin of the superior mesenteric artery. The left inferior suprarenal artery was originating from the left gonadal artery, which originated from the abdominal aorta in front of the left renal artery. Besides this, the left renal vein passed obliquely downwards behind the abdominal aorta and drained into the inferior vena cava. The retroaortic left renal vein may lead to unilateral hematuria, left varicocele and could be a cause of infertility in men.
The axillary arch is a rudimentary part of the latissimus dorsi. Generally it has a single insertion either into tendon of the pectoralis major, coracobrachialis or fascia over the biceps. Clinically, this anomalous muscular slip is known to cause neurovascular compression of nearby structures. The present case reports an unusual bifurcated fibrous insertion of an axillary arch with Y-shaped limbs. The stem of this muscle was a fleshy belly measuring 7.8 cm. The upper limb of this muscle, measuring 5.6 cm, was attached to the fascia covering the short head of biceps brachii and the coracoid process while its lower limb, measuring 5.1 cm, ended by merging with the brachial fascia over the biceps brachii below the deltoid muscle. The persistence of such a Y-shaped anomalous axillary arch might restrict the hyperabduction of the arm and compress the neurovascular structures passing below it.
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