Laparoscopic management of pelvi-ureteric junction obstruction caused by aberrant renal vessels in an adult

Pelvi-ureteric junction obstruction (PUJO) is not a rare clinical entity. It is indeed one of the common urological conditions presenting most commonly with hydronephrosis and pain. The most common etiology for patients suffering from acquired PUJO is the presence of calculus/calculi. An aberrant renal vessel (now termed as a vascular bar) is one of the causes in adults which are often missed on pre-operative investigations and is detected intraoperatively. We present herein the case of a 28 years old female who came with complaints of loin pain for 2 – 3 months. The workup investigations revealed only hydronephrosis without any calculi. Thus, a diagnosis of the primary PUJO was made. The patient was successfully managed by a laparoscopic pyeloplasty.

Horseshoe kidney with surplus renal vessels: A case report in Thai cadaver.

A horseshoe kidney (HK) was discovered in an 84-year-old Thai male cadaver during routine dissection. Inferior poles of the kidneys fused to form a parenchymatous isthmus and constituted a HK. The HK located anterior to the abdominal aorta and the inferior vena cava at a level lower than the normal kidney. Both renal hila directed anteriorly and ureters which drained from each pelvis descended anterior to the isthmus to enter the urinary bladder. Eight renal arteries and five renal veins were observed. In this case the bulky isthmus, anatomical abnormalities, and a variable blood supply were found in association with the HK. It is important to be aware of this anomalous existence in clinical practice, especially during kidney surgeries, kidney transplants, or surgical and endovascular procedures on the aorta.

Normal variations of renal vessels based upon the study of 240 living-donor nephrectomies / 대한비뇨기과학회지

A full understanding of the potential anatomical variations of the renal veins and its branches is imperative for donor nephrectomies. Preoperative renal angiography is the most important study to evaluate renal vascular anatomy. By this technique. the renal arteries are well visualized. but it is almost impossible to obtain the exact informations of the renal veins and its branches. To prevent extensive manipulation of the kidney by profuse bleeding. the exact information of the renal veins and its branches is very important. Based on intraoperative observation of 240 consecutive cases of donor nephrectomies. we observett. the common renal vein variants. Left renal veins usually had two branches; adrenal vein proximally and gonadal vein distally. Lumbar veins were identified in 112 cases(56.7%) Lumbar veins were connected to renal veins posteriorly near the draining site of gonadal veins. Therefore it is very important to dissect very carefully the posterior part of renal vein around the insertion of gonadal vein because of the existence of lumbar vein which might cause troublsome bleeding by accidental tearing. Especially when the cases of angulated renal veins were observed by renal angiography. the more attention will be required due to the strong possibility or the existence of lumbar vein.

Two Cases of Renal Vessel Malformation / 대한비뇨기과학회지

We have experienced two cases of renal vessel malformation caused by congenitally, one is extrarenal artery aneurysm with hypertension and the other is intrarenal arteriovenous fistula. We report two cases of renal vessel malformation and the literature has been reviewed.

OBSERVATION OF THE RENAL GLOMERULUS CASTS OF DOG UNDER THE SCANNING ELECTRON MICROSCOPE / 解剖学报

The kidneys removed from six female adult dogs were injected through the renal artery with ABS at a constant pressure between 33.3—33.7 kPa(250—280mmHg). Small specimens cut out from the kindneys were digested in 3％ trypsin solution for 48 hours and then eroded in 50％ HCl. The cast specimens were studied under the scanning electron microscope. The results were outlined as follows: 1. The corrosion-cast models of the renal glomerulus of the dogs observed under the SEM could be divided into three kinds: the spherical glomerulus, the chrysanthemum-like glomerulus and mixed glomerulus. 2. In general, the afferent and efferent arteriolae entered or exited at the hilum of glomerulus. Rarely, the efferent vessel left the glomerulus at the opposite side of the hilum. Anastomoses between the afferent and efferent or between the efferents vessels were found in our casts. 3. The capillary network of the juxtaglomerular apparatus was observed at the hilum of glomerulus in our casts. The diameters of the meshes of the capillary network were smaller than that of the vessels themselves.