A unique confluence of renal anatomical variations found during cadaveric dissection: A case report

• Author Details:   
• Rashi Sharma ^*
• Priya Parasappa Mudholakara
• Sunil Kumar Yadav
• Dharmendra Choudhary
• Sandeep Madhukar Lahange

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Anatomical variations in the renal and urinary systems, though often asymptomatic, hold significant clinical and surgical relevance. Variants such as bifid ureter, aberrant renal vessels, and polycystic kidneys may complicate diagnostic and operative procedures if unrecognized.

During a routine cadaveric dissection conducted in the Department of Rachana Sharir, anatomical variations were noted in a formalin-fixed 72 yrs old male cadaver of Indian origin. Following reflection of the posterior peritoneum and removal of overlying fascia and fat, the kidneys, ureters, renal vessels, and surrounding structures were carefully examined and documented. The cadaver presented with four notable renal anatomical variations: (1) Incomplete Bifid Ureter (Left Side, Unilateral): a unilateral left-sided incomplete bifid ureter, with two ureteric branches fusing 3.5 cm from the renal pelvis; (2) Multiple Tributaries of the Left Renal Vein: three distinct tributaries—designated as LRV1, LRV2, and LRV3—were observed draining the left kidney. These tributaries converged to form a single venous trunk, which subsequently drained into the inferior vena cava. (3) Early Division of the Left Renal Artery: the left renal artery was noted to bifurcate into segmental branches prior to its entry into the renal hilum, indicating an early prehilar division and (4) Bilateral polycystic kidneys, each containing 10–15 cysts, varying from 0.5 to 3.5 cm in depth, with dark, viscous fluid content. The coexistence of multiple renal anatomical variations in a single individual is rare and underscores the importance of awareness in clinical and surgical settings. Thorough anatomical knowledge is crucial in preventing iatrogenic complications during renal surgeries, transplants, or radiological interventions. Cadaveric studies remain invaluable for understanding such variations.

Keywords: Bifid ureter, Renal vein variation, Early artery division, Polycystic kidney, Cadaveric dissection