Unusual relationship of multiple renal arteries

Area of Science:

• Vascular anatomy
• Embryology
• Urology

Background:

• Renal artery variations can impact surgical and diagnostic procedures.
• Hematuria is a significant clinical symptom requiring thorough investigation.

Observation:

• Angiography revealed an uncommon arrangement of two left renal arteries in a young male patient.
• The upper pole renal artery originated from the aorta caudal to the lower pole artery.

Findings:

• This anatomical variation, termed a 'cross relationship,' was identified during the hematuria investigation.
• The embryologic basis for this anomaly is discussed, particularly in the absence of malrotation.

Implications:

• Accurate visualization of renal vasculature is crucial for managing conditions like hematuria.
• Combining selective renal arteriography with aortography is beneficial for detecting multiple renal arteries.