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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2011  |  Volume : 22  |  Issue : 5  |  Page : 1033-1034
Bilateral unrotation of kidneys


Department of Anatomy, Govt. Medical College, Miraj, India

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Date of Web Publication6-Sep-2011
 

How to cite this article:
Ramteerthakar RN, Joshi D S, Joshi R A, Pote A J. Bilateral unrotation of kidneys. Saudi J Kidney Dis Transpl 2011;22:1033-4

How to cite this URL:
Ramteerthakar RN, Joshi D S, Joshi R A, Pote A J. Bilateral unrotation of kidneys. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2022 May 20];22:1033-4. Available from: https://www.sjkdt.org/text.asp?2011/22/5/1033/84561
To the Editor,

Morphological variations of the kidney and its vessels are well known. During development, the kidney ascends from its original pelvic position to its definitive lumbar position at the end of the 5 th -8 th week of intrauterine life. It also undergoes rotation so that the hilum, which was initially facing its ventral aspect, comes to lie on its medial aspect. [1] However, in many instances, the rotation is incomplete or abnormal.

Here, we report the findings on an 82-year-old female cadaver observed during the dissection. She was found to have bilateral unrotation of the kidneys. Apparently, the lady had lived a normal life with these anomalies.


   Observations Top


  1. Three renal arteries were found on the right side. They were entering into the hilum of the right kidney.
  2. Two renal veins were found on right side. The upper one drained into the inferior vena cave and lower one into the right gonadal vein.
  3. On the left side, there were two renal arteries entering through the hilum.
  4. Two renal veins were found on the left side; the upper was draining into the inferior vena cava and lower was draining into the right gonadal vein.
  5. Because of the unrotation of the kidneys, the normal relations of the renal artery, vein and pelvis were all disturbed.

   Discussion Top


Very few cases of rotational anomalies of kidney have been reported. Rotational anomalies are often caused by or related to aberrant renal vessels. Abnormal rotation, or malrotation, is most commonly associated with an ectopic or fused kidney, but may also occur in kidneys that undergo complete ascent. [2] The true incidence of this type of anomaly is probably underestimated because, in many patients, there are no clinical manifestations. Different types of rotational anomalies have been noted by Braash and Weyrauch. [2],[3],[4]

  1. In unrotation, the renal pelvis presents itself ventrally in relation to the kidney mass. (As we found in the present case.)
  2. In incomplete rotation, the hilum presents ventromedially.
  3. In the more rare reverse and excessive rotation, the renal pelvis presents itself in a position depending upon the number of degrees through which rotation has occurred.
The laterally rotated kidneys were reported during the radiological investigation. [5] Some authors reported unrotated left kidney associated with an accessory renal artery. [6] Bayramoglu et al noted bilateral additional renal arteries and an additional renal vein associated with unrotated kidneys. [7]

The anomalies of kidneys have an importance in advanced surgical procedures like percutaneous nephrectomy and pre-operative diagnostic evaluation of kidney donors. The accessory renal arteries are clinically important. The surgeons need to keep their presence of mind while dissecting the peripheral fat over the renal poles. [8]

 
   References Top

1.Moore P. The developing human- clinically oriented embryology 2007;288-97.  Back to cited text no. 1
    
2.Braash WF. Anomalous renal rotation and associated anomolies. J Urol 1931;25:9.  Back to cited text no. 2
    
3.Weyrauch HM. Anomalies of renal rotation. Surg Gynecol Obstet 1939;69:183.  Back to cited text no. 3
    
4.Hollinshead WH. Anatomy for surgeons: The kidneys, ureter and suprarenal glands. 2 nd ed: Harper and Row publishers, New York, Vol. 2, chapt 10, 1971;518-73.  Back to cited text no. 4
    
5.Ingole IV, Ghosh SK. Laterally rotated kidney: a rare congenital anomaly. J Anat Soc India 2005;54(1):19-21.  Back to cited text no. 5
    
6.Atasever A, Hamdi Celik H, Durgun B, Yilmaz E. Unrotated left kidney associated with an accessory renal artery. J Anat 1992;181:507-8.  Back to cited text no. 6
[PUBMED]  [FULLTEXT]  
7.Bayramoglu A. Bilateral additional renal arteries and an additional right renal vein associated with unrotated kidneys. Saudi Med J 2003;24(5):535-7.  Back to cited text no. 7
    
8.Nathan H, Glezer I. Right and left accessory renal arteries arising from a common trunk associated with unrotated kidneys. J Urol 1984;132 (1):7-9.  Back to cited text no. 8
    

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Correspondence Address:
Ruta N Ramteerthakar
Department of Anatomy, Govt. Medical College, Miraj
India
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Source of Support: None, Conflict of Interest: None


PMID: 21912043

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