Two cases of abdominal aortic aneurysm associated with horseshoe kidney are presented and the litera ture is reviewed. Preoperative urog raphy is recommended in all but emergent cases. If the urogram is ab normal, aortography is indicated to confirm the diagnosis of horseshoe kidney and to determine the nature of the renal blood supply. If the renal blood supply arises from the aneu rysm or is from multiple small ves sels, resection may not be indicated because of the possibility of extreme operative difficulties. If the pelvis is split, extreme care must be taken to insure a watertight closure and to institute adequate drainage to avoid retroperitoneal inflammatory compli cations.
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