The Clinical Significance of a Retroaortic Left Renal Vein

PURPOSE: A retroaortic left renal vein (RLRV) is located between the aorta and the vertebra and drains into the inferior vena cava. Urological symptoms can be caused by increased pressure in the renal vein. To evaluate the clinical importance of RLRV, we reviewed patients' medical records and radiologic findings. MATERIALS AND METHODS: Nine patients who were studied with multidetector computed tomography at our institution from January 2003 to December 2009 had urologic symptoms with RLRV. We retrospectively reviewed these patients' medical records and analyzed their clinical characteristics. RESULTS: The patients' mean age was 46.0±20.1 years (range, 17-65 years) and the male to female ratio was 5 to 4. The urologic symptoms of the initial diagnosis were various (hematuria: 5 of the 9 patients; left flank pain: 4 of the 9 patients; inguinal pain: 1 of the 5 male patients; and gross hematuria: 1 of the 9 patients). The distribution among the type I, II, III, and IV of RLRV was 6, 2, 1, and 0 patients, respectively. The concomitant diseases were ureteropelvic junction obstruction (UPJO; 2 of the 9 patients) and varicocele (2 of the 5 male patients). One patient with UPJO underwent pyeloplasty and the other patient with UPJO underwent nephrectomy due to a nonfunctional atrophied kidney. The microscopic hematuria was not resolved with conservative management for long-term follow-up. CONCLUSIONS: Hematuria and inguinal or flank pain seem to be common in patients with RLRV. The most common type of RLRV was type I. It appeared that the microscopic hematuria continued in the long-term follow-up.