Two cases with fenestrations in the left renal veins for the passages of the renal, gonadal, and suprarenal arteries

Fenestrations in the left renal vein (RV) were detected in two Japanese cadavers: a 96-year-old male (Case 1) and an 81-year-old female (Case 2). In Case 1, four left RVs emerged anterior to the renal arteries at the hilum. Fenestration 1 (0.5 cm) was found in the second highest vein. Fenestration 2 (1.0 cm) was found in the third highest vein. Three left renal arteries originated from the abdominal aorta and the inferior branch passed through fenestration 1. The left testicular artery arising 3.5 cm distal to the second-highest renal artery traversed fenestration 2. In Case 2, a fenestration was observed 4.5 cm distal to the left RV drainage into the inferior vena cava. The left middle suprarenal and left ovarian arteries originating from the abdominal aorta at L1/L2 and L2, respectively, passed through the fenestration. These rare variations enhance understanding of the development of the renal, gonadal, and suprarenal arteries.