Abdominal aneurysm and horseshoe kidney: A case report and collective review

A major factor in the resection of an abdominal aortic aneurysm in the presence of a horseshoe kidney is the vascular supply to the kidney. The level at which the renal arteries originate from the aorta is inconstant and, in 80 percent of the cases, multiple vessels are present. It is necessary that the renal blood supply be demonstrated to ascertain resectability of the aneurysm. This is done by direct observation or operative aortography. If retraction of the renal isthmus is unsuccessful in providing adequate exposure of the aneurysm, division of the isthmus should be carried out to facilitate resection.