A Case of Abdominal Aortic Aneurysm with Horseshoe Kidney and Internal Iliac Artery Aneurysm with Venous Fistula

Abstract

A 73-year-old man suffering from left leg edema was found to have an abnormal abdominal mass. Preoperative 3-dimensional (3D) computed tomographic (CT) angiography revealed an abdominal aortic aneurysm with horseshoe kidney and an internal iliac artery aneurysm with venous fistula. Preoperative abdominal CT showed 2 accessory renal arteries. First, we successfully removed the aneurysm via a medial transperitoneal approach with a bifurcated graft, without resection of the renal isthmus. Second, we repaired the internal iliac artery aneurismal venous fistula via a retroperitoneal approach. Postoperatively, there was no evidence of renal dysfunction and the patient was discharged after an uneventful postoperative course.