Retroaortic left renal vein

Last revised by Dr Yuranga Weerakkody on 05 Apr 2021

Retroaortic left renal vein (RLRV) is a normal anatomical variant where the left renal vein is located between the aorta and the vertebra and drains into the inferior vena cava.

Its recognition is important in order to avoid complications during retroperitoneal surgery or interventional procedures 2.

Retroaortic left renal vein has an estimated prevalence of ~2% 3.

Urological symptoms can be caused by increased pressure in the renal vein resulting in venous hypertension. This is an atypical form of nutcracker syndrome. Patients can present with hematuria and recurrent left flank pain.

The retroaortic position of the left renal vein has four subtypes 4:

  1. RLRV joining the IVC in the normal position
  2. RLRV joining the IVC at the level of L4–5
  3. Circumaortic or collar LRV, having two limbs, one crossing anterior and one behind the aorta
  4. RLRV drains into the left common iliac vein

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Cases and figures

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  • Case 1
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  •  Case 3: MRI
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  • Case 4: CT
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  • Case 9: ultrasound
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