Variation in the Arrangement of Structures at Hilum of Human Kidney

Abstract

Context: There is a variation in the arrangement of structures at hilum which may create problem for the surgeon during dissection of hilum of kidney. Moreover, developmental anomalies like, constriction at pelviureteric region, double renal pelvis, accessory renal arteries etc are not uncommon. So, adequate anatomical knowledge of kidney specially at hilum is required for successful surgery of this reason. Objective: To study the variation in the arrangement of renal vessels and renal pelvis at hilum. Study design: Descriptive type. Place and period: Department of Anatomy, Mymensingh Medical College, Mymensingh, Bangladesh from January 2004 to June 2005. Materials and methods: A total of 100 fresh human kidneys of both sexes and sides were collected from the morgue of Mymensingh Medical College at postmortem. The selected cases were between 5 to 60 years of age. The samples were preserved to observe the variations in the arrangement of main structures at hilum of kidneys regardless of age groups. Results: When hilum of the kidneys viewed before backwards, anteriorly and at the middle, there was 1% variation in the arrangement of renal vessels but posteriorly renal pelvis was found in variably and it was double in 2% of kidneys. Posterior division of renal artery was present behind the renal pelvis in 12% of kidneys. Conclusion: Variation in the arrangement of structures at hilum was observed in 1% of kidneys. DOI: http://dx.doi.org/10.3329/bja.v10i2.17322 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 76-79

Anatomical and Embryological Study of Renal Hilum

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Study of Arrangement of Renal Hilar Structures in Human Cadavers

“…Knowledge of renal hilar structures variations is useful for operating surgeons to identify and individually clamp the hilar structures, which is advantageous over en-bloc clamping. Knowledge of branching pattern of the renal artery is very important for the proper analysis of radiographic interpretation of renal vasculature and for planning surgical procedures in cases of renal trauma, renal transplantation, and partial nephrectomy [18].The variations in the branching patterns of the renal vessels are critical issues and a challenging task for a radiologists who interpret renal angiograms and for the urologists who perform laparoscopies [19]. Several studies have reported that anomalous courses of the renal vessels which had crossed the renal pelvis, caused ureteropelvic obstructions [20,21].…”

Comprehensive Study of Arrangement of Renal Hilar Structures and Branching Pattern of Segmental Renal Arteries: An Anatomical Study

“…In 66.3%, the kidney's pelvis was the posterior-most structure. However, a study done in the Bangladesh population noted renal pelvis is the posterior-most structure in 100% of the kidneys [ 22 ]. Before performing various procedures, urologists need to have a thorough understanding of the arrangement of the renal hilar structures, as they will be performing hilar dissection and hilar vascular clamping [ 10 ].…”