Duplex kidney with triple renal arteries

Case contributed by Dr Mahmoud Ibrahim Mekhaimar

Presentation

Right loin pain.

Patient Data

Age: 40 years
Gender: Male

Right duplex malrotated kidney is seen and supplied by :

  • a renal artery that arises from the lateral aspect of the aorta measuring about 7 mm at maximum axial diameter supplying the upper pole
  • another branch arising from the aorta at the level of L3 vertebra supplying the mid pole
  • an accessory renal artery is seen arising from the right common iliac artery supplying the lower pole

Mild dilatation of the malrotated pelvis of the right kidney showing lower calyceal two small radiodense stones.

The left kidney is supplied by :

  • a main renal artery that arises from the lateral aspect of the aorta measuring about 7 mm at maximum axial diameter
  • small accessory renal artery seen arising from the anterolateral aspect of the aorta, at the level of the left main renal artery, supplying lower zone of the kidney and measures 3 mm at maximum axial diameter

Normal appearance of intra-renal arterial branches bilaterally. No definite stenotic lesion. No evidence of early branching.

Right adrenal hypodense lesion measuring about 2.5 cm along its maximum axial diameter, likely adenoma.

Special thanx to Dr. Mohamed Fouad, MD. Associate professor of Diagnostic and Interventional Radiology, Cairo University Hospitals. 

Case Discussion

Features are suggestive of right duplex malrotated kidney with triple arterial supply. A duplicated renal collecting system is a common anomaly. In the non-obstructed cases, the diagnosis can be difficult.

Duplex kidney shares the same venous drainage and renal capsule with the ipsilateral kidney, unlike supernumerary kidney; a rare congenital anomaly and more frequently seen on the left side which has its own separate venous drainage and collecting system.

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Case information

rID: 71873
Published: 31st Dec 2019
Last edited: 17th Oct 2020
System: Urogenital
Inclusion in quiz mode: Included

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