Horseshoe kidney with high bifurcation of abdominal aorta: a rare imaging finding

Rakhee V. Tepale, Rajeev Kumar Pal


Vascular variations of the bifurcation of the abdominal aorta (BAA) are rare, and they are usually discovered incidentally. We report a unique clinically and surgically significant case of variations of the abdominal aorta as related to the location and type of bifurcation. A high-positioned bifurcation of the abdominal aorta upon a horseshoe kidney at the level of upper L2 vertebral body was detected during contrast-enhanced abdominal computed tomography scan. Due to the halted ascent in horseshoe kidney, abdominal vascular anomalies are common: usually, multiple renal arteries arise from the distal aorta or iliac arteries; this is important when these patients undergo any procedure, particularly abdominal angiogram. The awareness of the variations of the abdominal aorta is of great importance during surgery and interventional radiological procedures to reduce complications during abdominal and spinal interventions, as well as for radiologists for precise interpretation of angiograms.


Abdominal aorta, Horseshoe kidney, Variation, Computed tomography

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Lee CH, Seo BK, Choi YC, Shin HJ, Park JH, Jeon HJ, et al. Using MRI to Evaluate Anatomic Significance of Aortic Bifurcation, Right Renal Artery, and Conus Medullaris When Locating Lumbar Vertebral Segments. American Journal of Roentgenology. 2004;182:1295-300.

Hager E, Isenberg G, Gonsalves C, Moudgill N, Dong S, DiMuzio P. A new anatomic variant of the aorta: a case report. J Vasc Surg. 2008;48:213-5.

Huang W, Ge G, Meng J, Xu Y. High bifurcation of abdominal aorta upon horseshoe kidney at the level of upper L2 vertebral body: a rare case report. Surg Radiol Anat. 2010;32:605-8.

Chithriki M, Jaibaji M, Steele R. The anatomical relationship of the aortic bifurcation to the lumbar vertebrae: a MRI study. Surgical and Radiologic Anatomy. 2002;24:308–12.

Glenn JF. Analysis of 51 patients with horseshoe kidney. N Engl J Med. 1959;261:684-7.

Boatman DL, Cornell SH, Kölln CP. The arterial supply of horseshoe kidneys. Am J Roentgenology. 1971;113: 447-51.

Bietz DS, Merendino KA. Abdominal aneurysm and horseshoe kidney: a review. Ann Surg. 1975;181(3):333–41.

Pirro N, Ciampi D, Champsaur P, Di Marino V. The anatomical relationship of the iliocava junction to the lumbosacral spine and the aortic bifurcation. Surg Radiol Anat. 2005;27(2):137-41.

Kara E, Yildiz A, Oztürk NC, Oztürk H. An extremely rare bifurcation pattern of the caudal abdominal aorta: case report demonstrated by angiography. Surg Radiol Anat. 2008;30(8):689-91.

Atalar MH, Salk I, Bozbiyik N, Cetin A. Diagnosis of High Bifurcation of the Abdominal Aorta with Associated Vascular Variations: Case Report with Multidedector Computed Tomography. Pol J Radiol. 2015;80:523–5.