Dr. med. Dirk Manski

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Renal Artery Anomalies

Supernumerary Renal Arteries

Definition:

More than one renal artery enters the kidney. The additional artery may originate from the aorta, the main renal artery (early division), or other major abdominal vessels like the celiac 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 are rare, such as three arteries, branches from the celiac trunk, or the superior mesenteric artery.

Fraley Syndrome:

A crossing renal artery branch obstructs the upper calyx with flank pain.

Ureteropelvic junction obstruction:

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

Diagnosis:

Depending on symptoms: i.v. urography, renal scintigraphy, Doppler ultrasound, CT angiography or MRI angiography. A separate scintigraphy analysis of the lower and upper pole renal is necessary for suspected Fraley syndrome.

Therapy:

Surgery is sometimes necessary to relieve symptoms. Pyeloplasty for UPJ-obstruction (please see section UPJ obstruction). Calicopyelostomy or partial nephrectomy for Fraley syndrome.






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  Deutsche Version: Fehlbildung der Nierenarterie