Unique Coexistence of Left Inferior Suprarenal, Accessory Renal, and Arched Testicular Arteries Arising From a Common Trunk: A Rare Vascular Variation With Dual Left Testicular Veins

Visceral blood vessels often display significant anatomical variability, with testicular artery (TA) anomalies more frequently observed on the left side. During a routine cadaveric dissection of an 88-year-old Caucasian male with no known kidney or testicular disease, a unique vascular pattern was identified. A left common trunk arose from the abdominal aorta at approximately the level of L2 vertebra, positioned partially behind the left renal vein. This trunk ascended and bifurcated into superior and inferior branches. The superior branch gave rise to a left inferior suprarenal artery and a left inferior polar renal artery. The inferior branch looped around the left renal vein and artery, continued as an arched left TA. The TA then traveled inferiorly, penetrating the deep inguinal ring and entering the spermatic cord. Additionally, two left testicular veins were observed traversing a typical course alongside the TA contributing to the left renal vein. This case presents a rare vascular configuration in which multiple individually reported variations - the left inferior suprarenal artery, inferior polar renal artery, and arched testicular artery - not only coexist, but all arise from a common trunk. To the best of our knowledge, this precise anatomical pattern has not been previously reported in the literature. The coexistence of dual left testicular veins further highlights the complexity of this case. Awareness of these anatomical variations is pertinent to surgical specialists and interventional radiologists in reducing complications in retroperitoneal procedures as well as improving procedural accuracy.