Variation in the position, relation and vasculature of left suprarenal gland: a case report

Prevalence and clinical relevance of the anatomical variations of suprarenal arteries: a review

The suprarenal arteries are arising from three sources: superior suprarenal artery, middle suprarenal artery, and inferior suprarenal artery. Variations in the arterial supply of the suprarenal glands in respect to origin and number are quite common and very frequently reported. The most common variation noted is in the inferior suprarenal artery followed by the middle suprarenal artery and the least common variations were observed in the superior suprarenal artery. Arteriogram of the inferior suprarenal artery is crucial in suprarenal tumour diagnosis but variation in the branching pattern and multiplicity of these arteries can cause hindrance in arteriography. The absence of middle suprarenal artery was seen to be associated with increased number of the inferior suprarenal artery. Variation in the multiplicity of arteries was observed more frequently in the inferior suprarenal artery and middle suprarenal artery which was more on the right side in most of the studies. Also, the variation in suprarenal arteries was often correlated to variations in inferior phrenic and gonadal arteries. The variations were observed to be more common on the left side therefore right adrenalectomy should be preferred over the left one. The loop formed by the inferior suprarenal artery around the right renal vein can cause venous obstruction. These variations of suprarenal vasculature are explained on the developmental basis, and prior knowledge of such variants is crucial for nephrologists to ensure minimum blood loss while performing laparoscopic adrenalectomy especially for large adrenal tumours and pheochromocytoma where the duration of surgery exceeds the usual.

A morphometric study of suprarenal gland development in the fetal period

PURPOSE

The present study's purpose was to examine the morphometric development of the suprarenal gland using anatomic dissection methods during the fetal period.

METHODS

This study was performed on 172 human fetuses (76 males and 96 females) and 344 fetal suprarenal glands obtained from ages 9-40 weeks of gestation with no external pathology or anomaly. Fetuses were divided into 4 groups between gestational ages as follows: Group 1, 9-12 weeks (first trimester); Group 2, 13-25 weeks (second trimester); Group 3, 26-37 weeks (third trimester); and Group 4, 38-40 weeks (full term). Also, the fetuses were grouped into monthly cohorts: 9-12 weeks 3rd month, 13-16 weeks 4th month, 17-20 weeks 5th month, 21-24 weeks 6th month, 25-28 weeks 7th month, 29-32 weeks 8th month, 33-36 weeks 9th month, and 37-40 weeks 10th month. The suprarenal glands were dissected in the abdominal cavity. The dimensions (width, length, and thickness), volumes and weights of the suprarenal glands were evaluated. The ratio of the fetal suprarenal gland weight/fetal body weight, the ratio of the fetal suprarenal gland volume/fetal kidney volume, and the ratio of the fetal suprarenal gland dimensions/fetal kidney dimensions were evaluated.

RESULTS

Mean values and standard deviations of all parameters according to gestational weeks and trimesters were calculated. It is found that all parameters increase with gestational age. There was significant correlation between gestational age and all parameters (p < 0.001). No significant differences were observed between sexes for any of the parameters (p > 0.05). There was no difference between the right and left sides of parameters except the thickness of the suprarenal glands. The left suprarenal glands were thicker than the right. The ratio of suprarenal volumes to kidney volumes was determined, and we observed that the ratio decreased during the fetal period.

CONCLUSIONS

We believe that the results obtained from this study will be beneficial in understanding the development of suprarenal glands and also contribute to future studies in obstetrics, perinatology, and fetopathology.