[Primary and secondary aortoiliac reconstructions in patients with coexistent horseshoe and pelvic kidney]

The coexistence of dystopic kidney and abdominal aortic aneurysm or aortoiliac occlusive arterial disease is uncommon (0.12-0.15 %) and constitutes a technical challenge to vascular surgeons. Between 1997 and 1999 we performed 249 aortoiliac reconstructions and encountered four patients (1.6 %) with dystopic kidneys. The aortoiliac reconstructions were performed successfully in all patients while maintaining renal blood supply. Aortoiliac reconstructions in patients with horseshoe or pelvic kidney show similar results as regular reconstructions on the condition that optimal preoperative diagnosis and operative technique are used considering atypical renal vessels. Nevertheless, pelvic kidneys can lead to serious complications as we describe in this report. On the basis of our patients anatomy, embryology and surgical management of this entity.