IJAR.2020.238

Type of Article:  Case Report

Volume 8; Issue 4.2 (December 2020)

Page No.: 7829-7834

DOI: https://dx.doi.org/10.16965/ijar.2020.238

SUPRADIAPHRAGMATIC ORIGIN OF RIGHT RENAL ARTERY FROM THORACIC AORTA: CASE REPORT AND LITERATURE REVIEW

Rameshbabu CS *1, Kumar A 2, Gupta OP 3, Sharma Y 4.

*1 Associate Professor of Anatomy, Muzaffarnagar Medical College, N.H-58, Opp. Begrajpur Industrial Area, Muzaffarnagar. (U.P) 251203 India.

2 Dr. O.P. Gupta Imaging Centre, Bachcha Park, Meerut- 250001, (U.P), India.

3 Senior Consultant Radiologist, Dr. O.P. Gupta Imaging Centre, Bachcha Park, Meerut, (U.P), India.

4 Yashika Sharma, BRDIT, Dr. O.P. Gupta Imaging Centre, Bachcha Park, Meerut, (U.P), India.

Corresponding Author: C.S. Ramesh Babu, Associate Professor of Anatomy, Muzaffarnagar Medical College, N.H. 58, Opp. Begrajpur Industrial Area, Muzaffarnagar- 251203. India. Mobile: +91- 9897249202. E-Mail: csrameshb@gmail.com

ABSTRACT

Numerical anomalies of renal arteries are frequently encountered at radiological investigations. Origin of main renal artery from abdominal aorta above the level of origin of celiac trunk and supplying normally positioned kidney is encountered occasionally. But ectopic supradiaphragmatic thoracic origin of main renal artery supplying a normally positioned kidney is extremely rare and reported only as case reports and till recently only ten such cases have been reported. Incidentally all cases reporting thoracic origin are right renal arteries.  The present case report is an incidental observation of origin of main right renal artery from thoracic aorta at the level of upper part of body of T-12 vertebra in a male patient undergoing contrast enhanced CT for suspected lung pathology. The normally positioned right kidney was supplied by an accessory renal artery arising just below the level of origin of superior mesenteric artery. Our literature search has yielded 23 cases (excluding the present case) out of which 19 were thoracic right renal arteries and 4 thoracic left renal arteries. Additionally the present case was associated with the presence of variations of celiac and superior mesenteric arteries in the form of gastrosplenic and hepatomesenteric trunks. This association of variant gastrosplenic and hepatomesenteric trunks with thoracic origin of main renal artery is reported for the first time. Knowledge of such rare variations is crucial for radiologists, surgeons and urologists for better outcome of surgical and interventional procedures.
KEY WORDS: Thoracic renal artery, Supradiaphragmatic renal artery, Ectopic renal artery origin, Hepatomesenteric trunk, Gastrosplenic trunk.

REFERENCES

[1]. Ozkan U, Oguzkurt L, Teran F, Kizilkilic O, Koc Z, Koca N. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2006; 12: 183-186. PMID: 17160802
[2]. Hazirolan T, Oz M, Turkbey B, Karaosmanoglu AD, Oguz BS, Canyigit M. CT angiography of the renal arteries and veins: normal anatomy and variants. Diagn Interv Radiol. 2011; 17: 67-73.
https://doi.org/10.4261/1305-3825.DIR.2902-09.1
[3]. Doppman J. An ectopic renal artery. Br J Radiol. 1967; 40:312-313.
https://doi.org/10.1259/0007-1285-40-472-312
PMid:6020832
[4]. Ichikawa T, Iino M, Kaizumi J, Hara T, Kazama T, Sekiguchi T, Hashimoto J, Nakamura M, Imai Y. A case of right renal artery originating from the thoracic aorta. Jpn J Radiol. 2014; 32 : 716-720.
https://doi.org/10.1007/s11604-014-0360-7
PMid:25217879
[5]. Matusz P, Miclaus GD, Gabriel A, Catereniuc I, Olariu S, Shane Tubbs R, Loukas M. Single ectopic thoracic renal artery associated with a normal kidney position and renal artery stenosis: a case report and review of literature. Rom J Morphol Embryol. 2015; 56 (2): 557-561.
[6]. Ishida M, Namiki Y, Watanabe M. Thoracic renal artery: a rare case of renal artery originating from the thoracic aorta and literature review. Anat Sci Int. 2016; 91: 211-214.
https://doi.org/10.1007/s12565-015-0290-1
PMid:26173984
[7]. Hatem MA, Gray R. Aberrant supradiaphragmatic renal artery. Journal of Biomedical Graphics and Computing. 2015; 5 (1): 20-22.
https://doi.org/10.5430/jbgc.v5n1p20
[8]. Patel K, Gandhi S, Modi P. Unusual origin of right renal artery: A report of two cases. J Clin Diagn Res. 2016; 10 (5): TJ03-TJ04.
https://doi.org/10.7860/JCDR/2016/18428.7823
PMid:27437328 PMCid:PMC4948504
[9]. Tegtmeyer CJ, Stanton LW. Thoracic origin of a single renal artery. JAMA. 1969; 209 (8): 1223.
https://doi.org/10.1001/jama.1969.03160210055019
PMid:5819680
[10]. Cerny JC, Karsch D. Aberrant renal arteries. Urology. 1973; II (6): 623-626.
https://doi.org/10.1016/0090-4295(73)90322-1
[11]. Schaffer R, Gordon DH, Glanz S. Renal artery originating above celiac axis. N Y State J Med. 1981; 81: 1109-1111.
[12]. Uchino A, Araki A, Tanaka M, Omoto T. Abnormally high origin of renal artery- a case report (in Japanese). Jpn J Clin Radiol. 1983. 28: 1001-1003. PMID:6663773
[13]. Van Baalen JM, van Bockel HJH, Overbosch EH. Thoracic origin of right renal artery. J Vasc Surg. 1994; 19 (4): 762-763.
https://doi.org/10.1016/S0741-5214(94)70059-1
[14]. Cocheteux B, Mounier-Vehier C, Gaxotte V, Mc Fadden EP, Francke JP, Beregi JP. Rare variations in renal anatomy and blood supply: CT appearances and embryological background. A pictorial essay. Eur Radiol. 2001: 11 (5): 779-786.
https://doi.org/10.1007/s003300000675
PMid:11372607
[15]. Sueyoshi E, Sakamoto I, Uetani M. Right renal artery originating above the celiac axis. J Vasc Surg. 2009; 49: 1588.
https://doi.org/10.1016/j.jvs.2008.11.068
PMid:19307084
[16]. Talovic E, Voljevica A. An unusual renal accessory artery originating from the thoracic aorta and its potential clinical implications. Acta Medica Academica. 2013; 42 (1): 80-82.
https://doi.org/10.5644/ama2006-124.74
PMid:23735070
[17]. Delasotta LA, Olivieri B, Malik A, Nguyen C, Bhatia V, Burke W. Thoracic renal artery: a rare variant. A case study and literature review. Surg Radiol Anat. 2015; 37: 561-564.
https://doi.org/10.1007/s00276-014-1379-2
PMid:25270524
[18]. Arazinska A, Polguj M, Wojciechowski A, Trebinski L, Stefanczyk L. An unusual case of left renal artery compression: a rare type of median arcuate ligament syndrome. Surg Radiol Anat. 2016; 38: 379-382.
https://doi.org/10.1007/s00276-015-1478-8
PMid:25940812 PMCid:PMC4823334
[19]. Stinson JM, Rivard AL, Mitchell ME. Intrathoracic origin of left renal artery. J Vasc Surg. 2016; 64 (6): 1851-1852.
https://doi.org/10.1016/j.jvs.2015.06.052
PMid:27871500
[20]. Saddoud N, Bouktif I, Gmiha B, Daghfous MH. Left renal artery originating from the thoracic aorta: Three dimensional imaging findings. Diagnostic and Interventional Imaging. 2017; 98 (4): 359-360.
https://doi.org/10.1016/j.diii.2017.02.001
PMid:28285894
[21]. Ashalatha K, Teresa Rani S, Pavana Kumari KV, Rayappa Hanok Sritej. A study of anomalies of renal arteries. MedPulse-International Journal of Anatomy. 2017; 1 (3): 49-52.
[22]. Gadabanahalli K, Bhat V. Thoracic origin of single right renal artery: Some interesting facets. Int J Angiol. 2017; 26 (04): 264-266.
https://doi.org/10.1055/s-0037-1604328
PMid:29142495 PMCid:PMC5685789
[23]. Rossi UG, Rolandi GA. Thoracic renal artery. Aorta 2019; 7: 96-97.
https://doi.org/10.1055/s-0039-1693987
PMid:31614380 PMCid:PMC6794141
[24]. Panagouli E, Venieratos D, Lolis E, Skandalakis P. Variations in the anatomy of the celiac trunk: A systematic review and clinical implications. Ann Anat. 2013: 195: 501-511.
https://doi.org/10.1016/j.aanat.2013.06.003
PMid:23972701
[25]. Whitley A, Oliverius M, Kocian P, Havluj L, Gurlich R, Kachlik D. Variations of the celiac trunk investigated by multidetector computed tomography: systematic review and meta-analysis with clinical correlations. Clinical Anatomy. 2020; 1-14.
https://doi.org/10.1002/ca.23576
PMid:32012339
[26]. Song SY, Chung JW, Yin YH, Jae HJ, Kim HC, Jeon UB, et al. Celiac axis and common hepatic artery variations in 5002 patients. Systematic analysis with spiral CT and DSA. Radiology. 2010; 255 (1): 278-288.
https://doi.org/10.1148/radiol.09090389
PMid:20308464
[27]. Ramesh Babu CS, Joshi S, Gupta KK, Gupta OP. Celiacomesenteric trunk and its variants a multidetector row computed tomography study. J Anat Soc Ind. 2015; 64: 32-41.
https://doi.org/10.1016/j.jasi.2015.04.007
[28]. Sureka B, Mittal MK, Mittal A, Sinha M, Bhambri NK, Thukral BB. Variations of the celiac axis, common hepatic artery and its branches in 600 patients. Indian J Radiol Imaging. 2013; 23: 223-233.
https://doi.org/10.4103/0971-3026.120273
PMid:24347852 PMCid:PMC3843330

Cite this article: Rameshbabu CS, Kumar A, Gupta OP, Sharma Y. SUPRADIAPHRAGMATIC ORIGIN OF RIGHT RENAL ARTERY FROM THORACIC AORTA: CASE REPORT AND LITERATURE REVIEW. Int J Anat Res 2020;8(4.2):7829-7834. DOI: 10.16965/ijar.2020.238