RESUMO
The renal arteries arise from the lateral side of the abdominal aorta at the L2 vertebral level, just below the origin of the superior mesenteric artery. Multiple aberrant renal arteries can pose difficulties in renal transplantation, interventional radiological and urological procedures, renal artery embolization, angioplasty, or vascular reconstruction for congenital and acquired lesions. We present a case of a left kidney supplied by the left renal artery along with superior and inferior polar arteries, arising from the aorta and inferior mesenteric artery respectively. The inferior mesenteric artery was crossed by the left ureter and inferior mesenteric vein. The superior polar artery gave rise to an inferior suprarenal artery making the variation important for clinicians and surgeons.
As artérias renais originam-se do lado lateral da aorta abdominal, no nível da vértebra L2, logo abaixo da origem da artéria mesentérica superior. A presença de múltiplas artérias renais aberrantes pode representar dificuldades para transplante renal, procedimentos radiológicos e urológicos intervencionistas, embolização da artéria renal, angioplastia e reconstrução vascular para lesões congênitas e adquiridas. Apresentamos um caso de rim esquerdo vascularizado pela artéria renal esquerda e pelas artérias polares superior e inferior, as quais se originavam da aorta e da artéria mesentérica inferior, respectivamente. A artéria mesentérica inferior era cruzada pelo ureter esquerdo e pela veia mesentérica inferior. A artéria polar superior dava origem à artéria suprarrenal inferior, o que torna essa variação importante para clínicos e cirurgiões.
RESUMO
Abstract The renal arteries arise from the lateral side of the abdominal aorta at the L2 vertebral level, just below the origin of the superior mesenteric artery. Multiple aberrant renal arteries can pose difficulties in renal transplantation, interventional radiological and urological procedures, renal artery embolization, angioplasty, or vascular reconstruction for congenital and acquired lesions. We present a case of a left kidney supplied by the left renal artery along with superior and inferior polar arteries, arising from the aorta and inferior mesenteric artery respectively. The inferior mesenteric artery was crossed by the left ureter and inferior mesenteric vein. The superior polar artery gave rise to an inferior suprarenal artery making the variation important for clinicians and surgeons.
Resumo As artérias renais originam-se do lado lateral da aorta abdominal, no nível da vértebra L2, logo abaixo da origem da artéria mesentérica superior. A presença de múltiplas artérias renais aberrantes pode representar dificuldades para transplante renal, procedimentos radiológicos e urológicos intervencionistas, embolização da artéria renal, angioplastia e reconstrução vascular para lesões congênitas e adquiridas. Apresentamos um caso de rim esquerdo vascularizado pela artéria renal esquerda e pelas artérias polares superior e inferior, as quais se originavam da aorta e da artéria mesentérica inferior, respectivamente. A artéria mesentérica inferior era cruzada pelo ureter esquerdo e pela veia mesentérica inferior. A artéria polar superior dava origem à artéria suprarrenal inferior, o que torna essa variação importante para clínicos e cirurgiões.
RESUMO
La irrigación renal incluye la arteria renal y las arterias renales accesorias. Uno de estos vasos accesorios es la arteria polar renal superior o inferior. Estos vasos tienen un desarrollo embrionario y un origen anatómico similar a la arteria renal, tanto en la aorta abdominal como en sus ramas. Irrigan los segmentos renales correspondientes y se ha observado que su obliteración puede ser causa de aumento de la presión arterial, al estimular un aumento de renina circulante. El objetivo de este trabajo, es presentar un reporte de caso clínico de paciente masculino de 24 años, sin antecedentes mórbidos. Consulta por un cuadro de cefalea y mareos de 2 semanas de evolución. Clínicamente se pesquisó aumento de presión arterial y obesidad, sin fiebre ni otros hallazgos significativos. Los exámenes complementarios arrojan las siguientes alteraciones: triglicéridos (aumentados), presión arterial (aumentada), renina (aumentada) y AngioTac de abdomen evidenció una arteria renal polar accesoria superior izquierda, con estenosis vascular. La literatura indica que la hipertensión arterial esta correlacionada con la obstrucción parcial o total de una arteria renal o de una rama accesoria. Esta alteración en la disminución del flujo sanguíneo podría estimular la liberación de renina al torrente sanguíneo, afectando la presión arterial. Nuestros hallazgos concuerdan con lo descrito en la literatura y requieren ser considerados en el diagnóstico de hipertensión arterial. Este caso evidencia la necesidad de realizar una revisión exhaustiva de la base anatómica de la medicina con un enfoque integrativo, lo que permitirá mejorar el diagnóstico, el tratamiento y el pronóstico de patologías donde esta información es poco clara o inexistente.
The kidney irrigation includes the renal artery and the accessory renal arteries. One of these accessory vessels is the superior or inferior renal polar artery. These vessels have an embryonic development and an anatomical origin similar to the renal artery, both in the abdominal aorta but also of its branches. Irrigate the corresponding renal segments and it has been observed that their obliteration may cause increased blood pressure, by stimulating an increase in circulating renin. The objective of this work is to present a clinical case report of a 24year-old male patient, with no morbid history. Consultation due to headache and dizziness symptoms with 2 weeks of evolution. Clinically increased blood pressure and obesity, without fever or other significant findings. Corresponding exams showed the following changes: triglycerides (increased), blood pressure (increased), renin (increased) and abdominal AngioTac showed a left upper accessory polar renal artery with vascular stenosis. The literature indicates that arterial hypertension is correlated with partial or total obstruction of a renal artery or an accessory branch. This alteration in the decrease in blood flow could stimulate the release of renin into the bloodstream, affecting blood pressure. Our findings agree with what is described in the literature and need to be considered in the diagnosis of arterial hypertension. This case demonstrates the need for an exhaustive review of the anatomical basis of medicine with an integrative approach. This would improve diagnosis, treatment and prognosis of pathologies where this information is unclear or non-existent.