The adrenal gland is a retroperitoneal organ closely associated with neighboring structures and large retroperitoneal vessels. This study aims to examine the vascular relationships of the adrenal glands.

We conducted an anatomical dissection of the adrenal glands from 40 fresh cadavers, all of whom had no history of retroperitoneal surgery. The dissection conditions were similar to those in living subjects, and all measurements were taken in situ.

On the right side, the average distance between the adrenal gland and the right renal vein was 13 mm (range: 0 to 20 mm). In one case, the adrenal gland was positioned directly on top of the right renal vein. The average length at which the right adrenal gland lay behind the inferior vena cava was 8 mm (range: 0 to 12 mm). In four cases, the right adrenal gland was lateral to the renal vein, while in six cases, this length exceeded 10 mm. On the left side, the mean distance separating the adrenal gland from the left renal vein was 8 mm (range: 0 to 18 mm), with eleven cases showing the adrenal gland resting directly on the left renal vein.

The right adrenal gland is closely associated with the inferior vena cava and often lies behind it, which may explain the frequent occurrence of inferior vena cava injuries during surgery. Conversely, the left adrenal gland maintains a close relationship with the left renal vein, often resting on it, underscoring the surgical risks associated with the left renal pedicle during left adrenal surgery.