Unique case of entwined left testicular and left renal artery forming an arterial arch over the left renal vein

Testicular arteries are the main arteries supplying the testis. An anatomical variation in the course of the left testicular artery and left renal artery is presented in this case report, highlighting its clinical implications. The left testicular artery had a high origin from the anterior aspect of the abdominal aorta and took a recurrent course. On reaching the upper border of the left renal vein, it looped over it and descended in front of it. The left renal artery had normal origin and normal course of its proximal half. Thereafter, it arched over the superior border of renal vein and appeared on its anterior surface to reach the renal hilum, causing a mild tortuous course of the artery. This arching of testicular artery and renal artery over the left renal vein might compress the renal vein resulting in renal vein hypertension. This unusual course might also compress the testicular artery causing testicular and pelvic varicocele. Hence, an abnormal course of testicular artery often warrants clinical attention because of its importance in maintaining thermoregulation and proper spermatogenesis of the testis.