Hydronephrosis by an aberrant renal artery: a case report

Area of Science:

• Urology
• Radiology
• Vascular Surgery

Background:

• Ureteropelvic junction (UPJ) obstruction is a common cause of hydronephrosis, particularly in pediatric patients.
• Aberrant renal arteries, found in approximately 30% of individuals, can cross anteriorly to the ureter, potentially leading to obstruction.
• While aberrant renal arteries are known to cause UPJ obstruction, diagnosis using advanced imaging modalities has not been widely reported.

Observation:

• A 36-year-old woman presented with right hydronephrosis.
• Initial investigations including kidney ultrasonogram and excretory urogram confirmed right hydronephrosis.
• Computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA) precisely visualized an aberrant renal artery contributing to the hydronephrosis.

Findings:

• CTA and MRA demonstrated a clear anatomical correlation between the aberrant renal artery and the observed hydronephrosis.
• Surgical exploration confirmed the findings from the advanced imaging studies.
• This case highlights the diagnostic utility of CTA and MRA in identifying aberrant renal artery-induced UPJ obstruction.

Implications:

• Computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA) are valuable tools for evaluating hydronephrosis caused by aberrant renal arteries.
• These advanced imaging techniques offer precise visualization, aiding in diagnosis and surgical planning.
• The findings advocate for the increased use of CTA and MRA in cases of suspected aberrant renal artery-related UPJ obstruction.