J Korean Soc Radiol.  2015 Jun;72(6):427-430. 10.3348/jksr.2015.72.6.427.

Absence of Orthotopic Renal Vein with Aberrant Suprarenal Venous Drainage: A Case Report

• Kim E
• Jeon YS
• Cho SG
• Hong KC
• Park KM
• Lee T

• KMID: 2098024
• DOI: http://doi.org/10.3348/jksr.2015.72.6.427

Abstract

A CT scan of a 49-year-old female incidentally revealed a tortuous vascular structure in the right suprarenal space. According to angiographic evaluation of the right renal vessels, the right renal artery was single with normal diameter, and there was no venous drainage through the main right renal vein (orthotopic renal vein). The venous drainage of the right kidney flowed through the tortuous suprarenal vascular structure into the inferior vena cava. The color Doppler ultrasound revealed the monophasic waveform in that vascular structure without flow disturbance. The renal function and the result of urinalysis of the patient were normal, and any other congenital malformation was not found. Absence of the orthotopic renal vein and aberrant suprarenal venous drainage is a very rare congenital anomaly, and it should be discriminated from the other pathologic conditions.

MeSH Terms

Drainage*
Female
Humans
Kidney
Middle Aged
Renal Artery
Renal Veins*
Tomography, X-Ray Computed
Ultrasonography
Urinalysis
Vena Cava, Inferior

Figure

• 

  Fig. 1 Coronal reformatted CT image (A) and volume rendered image (B) of the aberrent right renal venous drainage. A. Contrast-enhanced coronal reformatted abdominal CT showed tortuous dilated vascular structure (black arrow) in the right suprarenal space and a normal parenchymal enhancement of both kidneys. B. Anterior volume-rendered image from CT data showed tortuous dilated vascular structure (open arrowheads) in the right renal hilum and suprarenal space. Whereas normal left renal vein (black arrow) is seen at hilar portion, the orthotopic right renal vein is not seen. The aorta (*) is seen and the right renal artery (white arrow) is normally seen.

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  Fig. 2 Digital subtraction angiography (DSA) image showing the aberrent right renal venous drainage. A. In DSA image of the right renal arteriogram, the tortuous dilated vascular structure (black arrow) is visualized at hilar portion after the renal parenchyma was stained. The orthopedic renal vein is not observed at the expected location. B. In DSA image of the right renal arteriogram, the tortuous dilated vascular structure (black arrow) is visualized at the right suprarenal space just after the staining of hilar tortuous vessel. Still the orthopedic renal vein is not observed at the expected location.

• 

  Fig. 3 Color and spectral Doppler ultrasound of vascular structure located at the right suprarenal space showed in the monophasic waveform, suggesting continuous venous flow.

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