Retroaortic left renal vein - type I

Case contributed by Ammar Ashraf
Diagnosis certain


Bilateral flank pain with nausea, dysuria and hematuria. No fever.

Patient Data

Age: 45 years
Gender: Male

Two calculi with the larger one measuring 6 mm (average density=1000 Hounsfield units) seen in the right distal ureter, associated with mild proximal hydroureteronephrosis. Mild impression over the proximal right ureter by the right gonadal vein. Extrarenal pelvis, more prominent on the right side. Few tiny left renal calculi with the largest calculus at its upper pole measuring 3 mm (average density=300 HU). A few tiny concretions noted in the right kidney. Few small phleboliths seen in the pelvis. Few coarse calcifications seen in the prostate gland. No hydroureteronephrosis seen on the left side. No perinephric fat stranding/collection seen on either side. Right accessory renal artery and retroaortic left renal vein (anatomical variants). A small simple cortical cyst in either kidney.

Case Discussion

Incidental findings of bilateral accessory renal arteries, retroaortic left renal vein and extrarenal pelvis.

Mild right hydroureteronephrosis secondary to the distal ureteric calculi. Gonadal vein impression over the proximal right ureter also contributes to the dilatation of the right-sided collecting system.

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