Bilateral extra‐renal pelvises and calyxes with additional renal blood vessel variations identified in a single prosected medical school donor body

Abstract

While there are relatively commonly observed, reported anatomical variations associated with the posterior abdominal wall, especially with the kidneys, we report here over a dozen variations in one prosected medical school donor body (Caucasian, male, age 87, cause of death: sepsis). These variations could contribute significantly to negative outcomes, especially in surgical procedures. During a routine dissection, we found bilateral extra‐renal pelvises. In the right kidney, there were two extra‐renal major calyxes, and five extra‐renal minor calyxes (two extra‐renal minor calyxes from the superior major calyxes, and three extra‐renal minor calyxes from inferior major calyxes). In the left kidney, there were four extra‐renal major calyxes and two extra‐renal minor calyxes off the most inferior major calyx. In addition, we found four venous variations and four arterial anomalies including one in a major artery. Namely, there were bilateral accessory renal veins found at the hilum that drained into the posterior aspect of the inferior vena cava. There was an additional accessory left renal vein that drained into the left renal vein, at the junction of the left testicular and left suprarenal veins. There was also a left lumbar vein that drained into one of the accessory left renal veins. Regarding the arterial supply to the kidneys, there were two polar right renal arteries directly off the abdominal aorta in addition to two long hilar right renal arteries, and three left hilar renal arteries that branched individually from the abdominal aorta. Finally, there was a long left common iliac artery compared to the right common iliac artery. Anatomical variations within patients can be of no significance or can turn a routine surgical procedure into a hazardous process if unrecognized at the time of intervention. Further documentation of such anatomical variations in prosected donor bodies can further inform surgeons for the need for imaging prior to various surgical procedures.