Autopsy Findings in Conjoined Twin with Single Heart and Single Liver

Kar, Asaranti; Mohanty, Pramod K.; Kar, Tushar; Jagadish, B; Behera, Suresh Kumar; Nayak, Amarendra

doi:10.1155/2012/129323

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…The importance of autopsy for understanding conjoined twins was well illustrated in the case described by Asaranti et al ( 34 ) . It was imperfect twinning in thoraco-omphalopagus twins.…”

Section: Diagnosismentioning

confidence: 97%

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Imperfect twinning: a clinical and ethical dilemma

Denardin

Telles

Betat

et al. 2013

Rev. paul. pediatr.

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OBJECTIVE To review the history, epidemiology, etiology, gestational aspects, diagnosis and prognosis of imperfect twinning. DATA SOURCES Scientific articles were searched in PubMed, SciELO and Lilacs databases, using the descriptors "conjoined twins", "multiple pregnancy", "ultrasound", "magnetic resonance imaging" and "prognosis". The research was not delimited to a specific period of time and was supplemented with bibliographic data from books. DATA SYNTHESIS: The description of conjoined twins is legendary. The estimated frequency is 1/45,000-200,000 births. These twins are monozygotic, monochorionic and usually monoamniotic. They can be classified by the most prominent fusion site, by the symmetry between the conjoined twins or by the sharing structure. The diagnosis can be performed in the prenatal period or after birth by different techniques, such as ultrasound, magnetic resonance imaging and echocardiography. These tests are of paramount importance for understanding the anatomy of both fetuses/children, as well as for prognosis and surgical plan determination. CONCLUSIONS Although imperfect twinning is a rare condition, the prenatal diagnosis is very important in order to evaluate the fusion site and its complexity. Hence, the evaluation of these children should be multidisciplinary, involving mainly obstetricians, pediatricians and pediatric surgeons. However, some decisions may constitute real ethical dilemmas, in which different points should be discussed and analyzed with the health team and the family.

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“…The importance of autopsy for understanding conjoined twins was well illustrated in the case described by Asaranti et al ( 34 ) . It was imperfect twinning in thoraco-omphalopagus twins.…”

Section: Diagnosismentioning

confidence: 97%

“…A importância da autópsia para o entendimento dos gêmeos fusionados foi bem ilustrada no caso descrito por Asaranti et al ( 34 ) . Tratava-se de gemelaridade imperfeita em gêmeos tóraco-onfalópagos.…”

Section: Diagnósticounclassified

Imperfect twinning: a clinical and ethical dilemma

Denardin

Telles

Betat

et al. 2013

Rev. paul. pediatr.

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“…Including our patients, we found data of 158 thoracopagus and thoraco-omphalopagus sets in 7 case series,[ 1 2 3 4 5 6 7 ] 2 review articles,[ 8 9 ] and 36 case reports. [ 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 ] The age at surgery was mentioned for 63 sets ranging from 11 h–144 months, with a median age of 2.75 months (IQR = 5.5). Sex was documented in 77 sets with 23 males and 54 females (M: F = 1:2.3).…”

Section: R Esultsmentioning

confidence: 99%

Conjoined Thoracopagus Twins: A Systematic Review of the Anomalies and Outcome of Surgical Separation

Saxena

Sinha

Pathak

et al. 2023

African Journal of Paediatric Surgery

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Introduction: Conjoined twin is an extremely rare condition and requires a thorough knowledge of anatomy, and a multidisciplinary approach is essential to successfully separate the twins. Thoracopagus twins lie face to face and are attached from chest to upper abdomen. They are the most common among all the varieties but have a poor survival rate. Materials and Methods: This study is a review of literature from 2019 to the oldest via PubMed and Google Scholar using keywords: Conjoined twins, Thoracopagus twins, Thoracoomphalopagus and Thoraco-omphalopagus twins. The articles were reviewed for the description of the anatomy of shared organs, management and outcome of these twins. Results: One hundred and fifty-eight sets of thoracopagus and thoraco-omphalopagus twins including our twins were included in this study. Out of 158 reported thoracopagus twin sets in literature, with M: F ratio of 1:2.3, 71 sets were found to be non-operable and all of them subsequently expired; 82 sets were operated upon, out of which 83 babies survived, suggesting an overall surgical success rate of about 50%. Conclusion: Thoracopagus twins have a dismal prognosis. The most important decisive parameter for successful separation is the extent of sharing of organs between twins. The role of a motivated multidisciplinary team is also indispensable and cannot be overemphasised.

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