Horseshoe kidney: is there still a debate?

Horseshoe kidneys (HSK) represent an interesting surprise during anatomical dissections directed towards teaching of the urinary system. Clinically, the HSK limits access into the retroperitoneal space due to its location, orientation, and positioning of the ureters. In addition, its highly variable arterial and venous patterns provide great difficulties for surgeons during aortic aneurysm correction, and more recently, HSK transplantation. This case is a morphological study of a noticeably different HSK from the perspective of location, arterial blood supply, and venous drainage, which is further solidified by an embryological review. The debate is opened for further exploration into the theories associated with HSK ascent, its vasculature patterns, and the need for precise diagnostic imaging to serve preoperative planning.