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Magnetic resonance images, axial view (A) and coronal view (B).
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Mother's preoperative study protocol was uneventful, except for the finding in the renal artery resonance of a horseshoe kidney with fused lower poles and no major vascular or urological abnormalities (Fig. 1).
Isthmus of the horseshoe kidney in situ.
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A medial upper abdominal incision was made in order to approach the left segment of the kidney mobilizing the left colon until the isthmus was exposed (Fig. 2).
Black arrows show both renal arteries too far to make a common one.
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The two arteries were too distant to make a common one (Fig. 3), thus the superior artery was anastomosed end-to-end to internal iliac artery and inferior end-to-side to the external iliac artery; transected edge was left with no further treatment or suture (Fig. 4).
Dopler ultrasonography showing complete perfusion.
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Recipient developed a DGF and the laboratory tests showed acute tubular necrosis with good arterial perfusion demonstrated in Doppler ultrasonography (Fig. 5) and scintigraphy (Fig. 6) showing isotope's concentration without elimination.