Coexistence of Dual Hila, Double Renal Arteries, and Incomplete Ureteric Duplication in a Single Kidney: A Cadaveric Case Report

Isolated variations in the renal vasculature and the collecting system are relatively common and well-studied, however their coexistence in a single kidney as a complex anatomical constellation is less documented and clinically significant. Such variations may complicate radiological interpretations, and increase the risk of iatrogenic injury. These anomalies are thought to have an embryological origin involving the renal ascent, persistence of transient embryonic vessels, and early bifurcation of the ureteric bud during development.
We report a case of a left kidney exhibiting dual renal hila with separate vascular pedicles and incomplete ureteric duplication in an adult Sri Lankan male cadaver. During routine dissections the left kidney was seen to have two distinct renal hila, each supplied by an independent renal artery arising from the abdominal aorta at different vertebral levels, with corresponding venous drainage converging into the left renal vein. Two renal pelves originated separately at each hilum and continued as duplicated ureters that fused to form a single ureter before entering the urinary bladder. The contralateral right kidney showed a single hilum with dual renal arteries. This combination of dual renal hila, multiple renal arteries and veins, and incomplete ureteric duplication within a single kidney is exceptionally rare and, to the author's knowledge, represents the first documented cadaveric case from Sri Lanka. Awareness of such complex renal anatomical variations is essential for surgeons and radiologists to avoid diagnostic errors and operative complications. Detailed documentation of these anomalies contributes to anatomical literature and enhances clinical safety.