Horseshoe kidney is one of the most common congenital disorders of the kidney. The
simultaneous incidence of horseshoe kidney and abdominal aneurysm is very low (0.12%
of all cases of abdominal aortic aneurysm). In the first case, a 64-year-old male
patient was admitted with acute lower limb ischaemia. CT-angiography revealed an occluded
aortic aneurysm. During the emergency operation, the abdominal aneurysm was resected
and an aortobifemoral bypass procedure was performed sparing the kidney's isthmus.
In the second case, the abdominal complaints were caused by an infrarenal abdominal
aneurysm that involved both common iliac arteries. Aortobiiliac reconstruction was
performed with planned separation of the kidney isthmus and reimplantation of the
accessory renal artery. Symptomatic abdominal aortic aneurysm is an urgent indication
for reconstruction. The preoperative CTor MR-angiography play a key role in the indication
and planning of the reconstruction. It is highly important for the vascular surgeon
to have a clear picture of the blood supply of the horseshoe kidney and the urinary
tract along with the anatomy of the aorta before the operation. The transperitoneal
approach has several advantages over the retro peritoneal approach during vascular
reconstruction surgery.
