An Infarcted Horseshoe Kidney

This 64-year-old patient was admitted due to sudden-onset of abdominal pain and hypotension. Physical examination confirmed distension, abdominal guarding and a pulsatile mass. Imaging studies showed evidence of a sub-renal abdominal aortic aneurysm and horseshoe kidney. The left hemi-kidney presented signs of hypoperfusion (Figs. 1 and 2). The patient underwent emergency surgery. We performed left hemi-nephrectomy, endoaneurysmorrhaphy and the proximal anastomosis of a bifurcated bypass with vascular prosthesis (18 mm × 9 mm). The patient died during the course of operation due to uncontrollable ventricular arrhythmia and coagulopathy. Horseshoe kidney associated with abdominal aortic aneurysm is a rare finding.

Fig. 1

Fig. 2

The final diagnosis was abdominal aortic aneurysm and horseshoe kidney with segmental infarction.