Unusual course of accessory renal artery and its clinical significance : a case report

The renal arteries are a pair of lateral branches arising from the abdominal aorta below the level of superior mesenteric artery at the upper lumbar level (L1–L3). These arteries carry about 20% of the cardiac output to supply the organ that is about 1/100 of the total body weight. The right renal artery is longer in its course owing to the location of the abdominal aorta more towards the left side of midline. Each renal artery divides into anterior and posterior divisions at or very close to the hilum of the kidney. Further it divides into segmental arteries to supply the respective segments of the kidney being themselves the end arteries. Variation in the number, source, branching and course of the renal arteries are very common. These accessory renal arteries or the aberrant arteries account for about 30% of existence, while 70% owes for the normal type. Further there is a difference in terminologies related to an aberrant renal artery and an accessory renal artery. An accessory renal artery is the one that is accessory to the main artery accompanying the same towards the hilum and entering the kidney through the hilum to supply it, while the aberrant artery supplies the kidney without entering its hilum. Existence of the accessory and aberrant arteries is accountable in cases of renal pathologies, radiological interventions, renal transplants, and other surgical approach on them. Altered state of hemodynamics was thought of in cases of multiple arteries supplying it. In the present study we reported the unusual course of accessory renal artery and associated clinical significance of the same.