Rusu M C
Department of Anatomy and Embryology, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, Bucharest.
Rom J Morphol Embryol. 2006;47(2):197-200.
During educational dissections at a human adult specimen, male, a complex picture of anatomical variants was encountered. Bilateral doubled renal arteries were found: on the right side superior hilar and inferior hilar renal arteries and on the left side superior hilar and inferior polar renal arteries. All these renal arteries emerged from the abdominal aorta. Also bilateral doubled testicular arteries were found. On the right side the medial testicular artery emerged from the abdominal aorta while the lateral testicular artery left the superior renal artery. On the left side the lateral and medial testicular arteries emerged as a common trunk from the abdominal aorta. This trunk originated from aorta behind the left renal vein and arched over that vein to descend and to divide in front of it. The two kidneys were keeping a fetal aspect, lobulated, more obvious on the left side. The right hepatic artery was found originating from the superior mesenteric artery; it coursed posterior to the portal vein and was sending the cystic artery. The right gastric artery emerged from the initial segment of the gastro-duodenal artery. Even though some morphological and topographical aspects regarding this complex anatomical variation have been described, it seems that the bilateral presence of doubled renal and testicular arteries has not been reported. The left testicular trunk arching over the left renal vein must be considered when discussing the nutcracker syndrome. During diagnostic and surgical approaches at the levels of the renal, gonadal and hepatic vessels, associations of anatomical variants and the bilateral presence of these must be suspected.
在对一具成年男性人体标本进行教学解剖时，发现了复杂的解剖变异情况。发现双侧肾动脉重复：右侧有肾门上极动脉和肾门下极动脉，左侧有肾门上极动脉和肾下极动脉。所有这些肾动脉均发自腹主动脉。还发现双侧睾丸动脉重复。右侧，睾丸内侧动脉发自腹主动脉，而睾丸外侧动脉起自肾动脉上支。左侧，睾丸外侧动脉和内侧动脉以共同主干发自腹主动脉。该主干起自左肾静脉后方的主动脉，跨过该静脉呈弓形下降，并在其前方分支。双侧肾脏呈胎儿期形态，分叶状，左侧更明显。发现右肝动脉起自肠系膜上动脉；它走行于门静脉后方，并发出胆囊动脉。胃右动脉起自胃十二指肠动脉起始段。尽管已经描述了关于这种复杂解剖变异的一些形态学和局部解剖学方面，但双侧肾动脉和睾丸动脉重复的情况似乎尚未见报道。在讨论胡桃夹综合征时，必须考虑左侧睾丸动脉主干跨过左肾静脉这一情况。在对肾、性腺和肝血管进行诊断和手术操作时，必须怀疑解剖变异及其双侧存在的关联性。
