Unusual Right Gonadal Vein Drainage: A Journey Into Rarity

Abstract

The gonadal veins, responsible for draining from the paired gonads (testes in males and ovaries in females), exhibit variations in anatomy. Traditionally, the right gonadal vein directs its drainage into the inferior vena cava, while the left gonadal vein typically connects to the left renal vein. However, in the case of a 45-year-old woman diagnosed with a non-functional right kidney who underwent a right nephrectomy, an intraoperative observation revealed an unusual configuration: the right gonadal vein (ovarian) was found to drain directly into the right renal vein instead of its usual route into the inferior vena cava. This case report aims to elucidate this anomalous finding and provide a literature review on the prevalence of such anomalies in the existing research. This case report aims to raise awareness about the atypical drainage patterns of gonadal veins and underscore the importance of meticulous dissection of hilar renal vessels.

Keywords: gonadal vein; inferior vena cava; ovarian vein; pelvic venous drainage; renal vein; testicular vein; venous anomaly.

Figure 1. Computerized tomography of the kidney, ureter, and bladder suggesting right poorly functioning kidney with hydroureteronephrosis (green arrow).

Figure 2. Renal scintigraphy scan showing homogeneous cortical tracer extraction over the left kidney but no significant appreciable cortical tracer extraction or tracer excretion noted throughout the study over the right kidney.

Figure 3. Intraoperative discovery of anomalous venous drainage of the right gonadal vein draining into the right renal vein and not the inferior vena cava.