Double left renal vein associated with abdominal aortic aneurysm

Double left renal vein is a rare venous anomaly. We operated on 72-year-old man of abdominal aortic aneurysm (AAA) with double left renal vein. Massive hemorrhage was encountered during encircling the tape around the abdominal aorta. One vein passing posterior to the aorta was injured. Further dissection revealed the presence of double left renal vein forming a ring around the aorta. The patient underwent an abdominal aortic replacement following prompt repair of the injured vein. He had an uneventful postoperative course without renal complication. We missed that preoperative computed tomographic (CT) scan had demonstrated double left renal vein. Preoperative contrast-enhanced CT scan is useful and essential not only for evaluation of AAA, but also for establishing the presence of venous anomalies. Venous anomalies should be taken into consideration on the AAA operation.