A pelvic kidney is a rare congenital anomaly. In patients requiring aortic surgery, the diagnosis of associated pelvic kidney is always challenging. This anomaly is best known for being associated with abdominal aortic aneurysm and rarely, with aortoiliac occlusive disease. We report the case of a 59-year-old man who presented with critical left lower limb ischemia secondary to bilateral iliac occlusion associated with pelvic kidney. He underwent aortofemoral bypass with an uneventful outcome.
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