Abstract

A74-year-old man presented emergently with acute left flank pain. Examination revealed a tender, distended abdomen. A single image from the enhanced abdominal computed tomography scan revealed a leaking abdominal aortic aneurysm (AAA) and horseshoe kidney (HK), with a 3.5-cm solid mass in the left lower pole (Fig. 1). The patient became hypotensive and was immediately taken to the operating room.

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