Abstract
Two cases of abdominal aortic aneurysm concurrent with horseshoe kidney are described. Both 66- and 75-year-old men were seen at the hospital because of an abdominal tumor which was pointed out at another hospital during the therapy for another disease. In each case, ultrasonography, CT, and aortography revealed an abdominal aneurysm and horseshoe kidney overlying on the ventral surface of the aneurysm. The isthmus of horseshoe kidney was composed of normal parenchyma. In both cases, two pairs of arteries running to the left or right side of the kidney wee demonstrated by the aortogram, but the fifth relatively small artery originating from the aortic bifurcation or common iliac artery was only found intraoperatively. Aneurysmectomy was performed successfully without dividing the isthmus of horseshoe kidney in both patients. One of the renal arteries in case 1 was reconstructed after cutting, but the lowest one to the left kidney in case 1 and that to the right kidney in case 2 were cut and ligated without significant renal damage. In the operation there are two problems that whether the isthmus should be cut, and how treatment should be given to the renal artery, and we are often obliged to make the final decision during surgery. We should entertain and prepare for all possibilities including the existence of abnormal renal arteries before operation.
