In conclusion, it can be seen that coexistent intra-abdominal pathology and aortic aneurysms demands an individualized approach to determine a treatment plan for a given patient. Life expectancy must be balanced against the risk of a complication developing in either the treated or untreated condition as well as the potential for increased morbidity associated with combined procedures. If combined procedures are performed, they must be undertaken only if the aneurysm resection has gone smoothly. Efforts must be directed at protecting the prosthetic graft from direct contamination that may accompany the secondary procedure. In general, the symptomatic lesion should be treated first. If both conditions are asymptomatic, the relative risks and benefits of treatment must be balanced against the probability that one or both of the conditions will become symptomatic.