An exclusion technique was utilized in dealing with an abdominal aortic aneurysm with an overlying horseshoe kidney. Use of this technique rather than symphysiotomy was necessitated by 1) a primative collecting system which joined together anteriorly to form a single midline ureter, and 2) a large anomalous renal artery which supplied the mid portion of the horseshoe kidney. The lack of filling of the excluded segment indicated that the lumbar arteries supplied little retrograde flow and therefore the subsequent risk of late rupture of the excluded segment was nil.
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