Duplicated left renal vein with aberrant inferior drainage to left common iliac vein: A rare anomaly of left renal vein

Anatomical variations of the renal veins, such as duplicated renal veins, are usually asymptomatic and frequently discovered incidentally on imaging. While clinically silent, recognizing these anomalies is of paramount importance for surgical planning and avoiding diagnostic errors. We report the case of a 66-year-old man who presented to the emergency department with a persistent cough and exertional dyspnea. The patient had no significant past medical history, and physical examination and laboratory tests were unremarkable. To evaluate his respiratory symptoms, a triphasic contrast-enhanced computed tomography (CT) scan was performed. Although no acute thoracic pathology was found, the imaging incidentally revealed a duplicated left renal vein. An accessory vein originating from the lower pole of the left kidney, coursing inferiorly and draining into the left common iliac vein at the level of the inferior vena cava (IVC) bifurcation, visualized as a patent vessel in all contrast phases. No other abdominal or vascular anomalies were observed. This case highlights that duplicated renal veins can be incidentally detected on CT scans performed for unrelated, non-abdominal indications. Accurate radiologic identification and documentation of such venous variants are essential to prevent misdiagnosis (such as mistaking the vessel for a retroperitoneal mass or lymph node) and to avoid perioperative complications in future retroperitoneal, vascular, or urological procedures.