Retro-aortic left renal vein draining into left common iliac vein: A rare renal vein anomaly and its significance

INTRODUCTION: Anomalies of renal vessels are rare and asymptomatic. It poses a great challenge during renal and retroperitoneal surgeries. Injury to anomalous renal vessels can lead to major morbidity and even mortality. Preoperative imaging like CT scan, MRI scan helps to identify these vessels and helps in planning of surgery avoiding injury.

CASE REPORT: A 59-year-woman, a diagnosed case of carcinoma endometrium underwent extra fascial hysterectomy with bilateral pelvic lymph node dissection and para aortic dissection. Intra operatively a rare anomaly of Left renal vein was identified. Left renal vein was coursing posterior and lateral to aorta and caudally draining into Left common iliac vein. Para-aortic lymph node dissection was done safely, securing the anomalous left renal vein.

CASE DISCUSSION: Various anomalies of renal vein were described in literature. Pre-operative identification of anomalous vessels and careful dissection intra-operatively can help in avoiding injury to these vessels. Awareness of such an anomaly has to borne in mind, although rare, it can prevent catastrophes.