Dr. med. Dirk Manski



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Renal Artery Anomalies

Supernumerary Renal Arteries

Definition:

If more than one renal artery enters the kidney, these are called supernumerary renal arteries. Supernumerary renal arteries may originate from the aorta, from the main renal artery (early division) or from other major abdominal vessels like celiac artery or superior mesenteric artery (aberrant renal artery).

Pathology:

70–85% of the kidneys have a single renal artery originating from the aorta. The renal artery divides into 4–5 segmental arteries.

Anomalies:

Additional arteries to the upper or lower pole are common (each about 6%). More complex abnormalities such as three arteries, branches from the celiac trunk or the superior mesenteric artery are rare.

Fraley-Syndrom:

Obstruction of the upper calyx by a crossing renal artery branch is causing flank pain.

Ureteropelvic junction obstruction:

Due to an additional subpolar artery, see section UPJ obstruction.

Diagnosis:

i.v. urography, renal scintigraphy, Doppler ultrasound, CT- or MRI angiography. For suspected Fraley syndrome, a separate analysis of the lower and upper pole renal is necessary in renal scintigraphy.

Therapy:

In rare cases, surgery is necessary for the relief of symptoms: Fraley's syndrome can be treated by calicopyelostomy or partial nephrectomy. For the treatment of hydronephrosis due to UPJ-obstruction, please see section UPJ obstruction.







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  Deutsche Version: Fehlbildung der Nierenarterie