Double Retroaortic Left Renal Vein:
report of an Uncommon Anatomical Variation
Abstract
The retroaortic left renal vein is a rare anatomical variation of the cavorenal venous system, of embryological origin, with relevant clinical and surgical implications in vascular, urological, and transplant surgery.
Objective: To describe a rare anatomical variation of the left renal vein, specifically a double retroaortic left renal vein, highlighting its clinical, surgical, and embryological relevance.
Materials and methods: A routine cadaveric dissection was performed on an adult male specimen fixed in 10% formalin. Photographic and schematic documentation of the finding was carried out.
Results: A left renal vein was identified that originated as a single trunk which bifurcated into two branches (superior and inferior) after a short course. Each branch received specific tributaries: the superior branch received the left inferior phrenic vein, and the inferior branch received the left gonadal vein. Both branches followed a retroaortic course, forming an arch before converging into a common trunk and draining into the
inferior vena cava at the level of the second lumbar vertebra. An atypical arrangement of the renal hilum and an early arterial bifurcation were also observed. This configuration represents an extremely rare variant, distinct from the classic classifications. Its origin is explained by alterations in the persistence of embryonic venous anastomoses.
Conclusion: The presented variation highlights the complexity of the left renal venous system and has relevant surgical implications, especially in aortic surgery, kidney transplantation and nephrectomies, where it increases the risk of vascular injury. Its recognition is fundamental in preoperative planning and in anatomical teaching, underscoring the value of dissection in understanding rare variants.
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