A case of thoraco-omphalo-ischiopagus bipus conjoined twins

Melikoğlu, Mustafa; Aslan, Adnan; Mete, Atalay; Özkaynak, Can; İnan, Mustafa; Karaveli, Şeyda

doi:10.1016/s0022-3468(97)90735-1

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…At the other end of the spectrum, a more overlapping pelvic bony fusion between both twins can be seen on the posterior side with hypodeveloped fused pelvic bones. 6 7 8 9 13 This is associated with concomitant hypodevelopment of lower extremities and urinary tract on the same side. The degree of hypodevelopment and overlapping fusion on the posterior side is proportionate to the number and development of lower limbs: ischiopagus with tetrapus, tripus, or bipus (four, three, or two lower limbs, respectively).…”

Section: Discussionmentioning

confidence: 99%

Ventrally Fused Conjoined Twins (Omphaloischiopagus): A Roadmap to Successful Separation

AbouZeid

Mohammad

Radwan

et al. 2022

European J Pediatr Surg Rep.

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Conjoined twining is one of the most fascinating and challenging situations which a pediatric surgeon may face in his career. Only few surgeons may have the opportunity to share in separation of such cases. In this report, we aim to share our experience with the successful separation of ventrally fused male conjoined twins (omphaloischiopagus). The case was thoroughly studied via preoperative cross-sectional imaging modalities (magnetic resonance imaging [MRI] and computed tomography [CT] angiography), complemented by data obtained from reviewing similar cases in the literature. A clear delineation of the complex anatomy was achieved preoperatively which proved to be well consistent with the operative findings. A detailed description of the operative procedure to divide/redistribute the shared abdominal/pelvic organs between both twins is provided. To the best of our knowledge, this is the first report to describe the detailed and unique internal anatomy of a common central phallus associating ischiopagus conjoined twins. The penis was centrally located in the perineum in between both twins with an open urethral plate. This common phallus had a peculiar configuration with four crura anchoring ischial bones of both twins together.

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Section: Discussionmentioning

confidence: 99%

Ventrally Fused Conjoined Twins (Omphaloischiopagus): A Roadmap to Successful Separation

AbouZeid

Mohammad

Radwan

et al. 2022

European J Pediatr Surg Rep.

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“…The indications for emergency surgery include the following: one twin is stillborn or has anomalies incompatible with survival; damage to the connecting bridge; ruptured omphalocele or other life-threatening event; and congenital anomalies that are surgically correctable but would be fatal if not treated (12). The goal of separation is the survival of one or both twins with a reasonable quality of life (2,14). In emergency situations, the twins are in unstable condition, and plain radiography, echocardiography, and US are usually performed as bedside examinations in the neonatal intensive care unit.…”

Section: Surgical Considerationsmentioning

confidence: 99%

Imaging in the Preoperative Assessment of Conjoined Twins

Kingston

McHugh²,

Kumaradevan³

et al. 2001

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Conjoined twins are rare and present a unique challenge to pediatric surgeons and radiologists. Planning of surgical separation is aided by accurate preoperative imaging. Such twins are classified according to the most prominent site of connection: the thorax (thoracopagus), abdomen (omphalopagus), sacrum (pygopagus), pelvis (ischiopagus), skull (craniopagus), face (cephalopagus), or back (rachipagus). The area of fusion largely determines the imaging modalities used. Thoracic conjunction is most common and requires cardiac assessment. Magnetic resonance imaging and computed tomography provide excellent anatomic and bone detail, demonstrating organ position, shared viscera, and limited vascular anatomy. Contrast material radiography allows evaluation of the gastrointestinal and urogenital tracts, and a shared liver requires assessment of anatomy, vascularization, and biliary drainage. Angiography helps define specific vascular supply, which is useful in determining the distribution of shared structures between the twins at surgery. Each set of conjoined twins is unique. An imaging strategy to accurately define anatomic fusion, vascular anomalies, and other associated abnormalities is important for surgical planning and prognostic information.

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