Atypical twin renal arteries with altered hilar anatomy

Twin renal arteries (superior and inferior) were encountered on the left side in a 58-year-old male Indian cadaver. Both the renal arteries took a tortuous course to the hilum. The inferior renal artery, labeled as the accessory renal artery travelled sinuously and anteriorly over the left renal vein to enter the inferior most part of the hilum. The superior artery, labeled as main renal artery bifurcated before the hilum and its two branches were placed anterior to the vein. Thus the normal anteroposterior disposition of structures viz. renal vein, renal artery and the renal pelvis was not seen. Such renal arteries having sinuous course with atypical sequence of structures at the hilum are of worth concern to the urologists performing renal angiography and to surgeons performing laparoscopies or renal transplantation.