Anatomical and topographical variations of the left renal vein have been investigated and expounded by anatomists and pathologists for nearly two centuries.1-7 Little emphasis has been placed by surgeons and radiologists on the anomalies of the renal vein until recently. Primary involvement of the renal veins, such as in renal vein thrombosis, retroperitoneal fibrosis, and arteriovenous fistula, has attained clinical significance during the past decade. The location and anatomy of the renovascular pedicle is of great value during surgical procedures on the abdominal aorta, superior mesenteric and renal arteries, splenorenal and mesorenal shunts, inferior vena caval interruption, sympathectomy, nephrectomy, and during operations on the renal pelvis. Atypical levels of drainage and anatomical variations of the renal veins are also vital in the selection of donors for renal transplantation and venin assays by inferior vena caval catheterization in diagnosis of patients with renovascular hypertension.
During the past few years, after