Dicephalus dipus tetrabrachius conjoined twins of Zaria: Case report and literature review

Ibinaiye, PO; Mshelbwala, P. M.; Abdulgafar, N; Lawal, AK

doi:10.4103/1119-3077.113473

Cited by 6 publications

(10 citation statements)

References 6 publications

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“…When the anomaly is incompatible with postnatal life, termination of the pregnancy has been recommended and this option should be made available to the families. 4 In the conjoined twins, the structure they share or own independently is one point of discussion. In our case, the twins have separate lungs, which are paired for each.…”

Section: Discussionmentioning

confidence: 99%

“…Dicephalus (two heads), tetrabrachius (four upper limbs) and bipus (two lower limbs) is one of the rarest forms of conjoined twins. 4 Generally, multiple factors, such as alcohol consumption, drug use, radiation or chemical exposure, and lack of folic acid supplementation during pregnancy, as well as family history, are reported risk factors for the development of congenital anomalies. 5,6 Specific to conjoined twins, the exact etiology has not been discovered yet.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Ischiopagus Dicephalus Conjoined Twins with Tetrabrachius Bipus from Dessie, Ethiopia

Alene¹,

Abebe²

2022

IMCRJ

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The development of conjoined twins always catches the eyes of researchers and clinicians. Beyond the rareness of the cases, how they develop is a debatable issue. This report presented a case of ischiopagus conjoined twins who had two heads (dicephalus), four upper extremities (tetrabrachius), and were joined below the chest with two lower extremities (bipus). The twin's mother was referred from a primary hospital to Dessie Comprehensive Specialized Hospital for proper management of twin pregnancy, where a cesarean section was performed. The mother and her husband have no family history of birth defects or exposure to known teratogens. On imaging, the twins had separate hearts, lungs, and kidneys but a single liver, spleen, stomach, and intestine. They also shared genitourinary structures: a single penis with sub-coronal hypospadias and one imperforate anus. In addition, their placenta was single with one umbilical vein and two umbilical arteries. The conjoined twins had multiple accompanying cardiovascular anomalies but no external craniofacial, extremity, or brain anomalies. They passed away after 36 hours of follow-up in the neonatal intensive care unit at Dessie Comprehensive Specialized Hospital.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Ischiopagus Dicephalus Conjoined Twins with Tetrabrachius Bipus from Dessie, Ethiopia

Alene¹,

Abebe²

2022

IMCRJ

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“…It eliminates iatrogenic effects of prolonged transportation on the child's health condition and enables proper preparation of the specialist centre [5]. It should be however borne in mind that Siamese twins are such a complicated developmental defect that even the use of the most advanced diagnostic methods does not always allow to assess accurately the configuration of twins' internal organs, hence final verification is possible only on the operating table [19].…”

mentioning

confidence: 99%

“…However, it should always be taken into account that the condition of one of the twins can deteriorate and emergency operation can be necessary [6,12,13,19,21]. It has been demonstrated that the postponement of separation surgery until the twins are several months old, unless life threatening, increases the chances of good outcomes.…”

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confidence: 99%

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Znieczulenie bliźniąt syjamskich

Kobylarz

2014

Anaesthesiol Intensive Ther

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Conjoined twins have been a source of fascination to the public and the medical profession for centuries. Their birth was initially viewed as an ominous sign of impending disaster. Since Middle Ages into the 19 th century they were regarded as monstrosities and were exhibited at circuses and sideshows. The frequency of conjoined twins is approximately 1 in 50,000 gestation, but many of them die in utero, are terminated or stillborn. The true incidence is estimated to be 1 in 200,000 live births. This article gives an overview of Siamese twins and of the prenatal diagnosis in assessing the prognosis, anaesthetic and post-natal surgical management and outcome. Anaesthesia for conjoined twins surgery, whether prior to or for separation, is an enormous challenge to the anaesthesiologist. The site and complexity of the conjunction affect management of the airway, an intravenous access, the extent of blood and number of surgical specialties involved. Preoperative assessment and planning with interdisciplinary communication and cooperation is vital to the success of the operations. Meticulous attention to detail, monitoring and vigilance are mandatory.

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Anesthetic management of omphalopagus twins with pentalogy of Fallot undergoing separation surgery

Purwoko,

Santosa,

Novianto

et al. 2023

Anaesth. pain intensive care

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The management of conjoined twins has several special aspects, mostly linked to the parents of the twins, such as communication, ethics and trust issues. A multidisciplinary team approach plus high level of vigilance at each perioperative stage is required. Conjoined omphalopagus twins, aged one year, were planned for separation surgery. They had fused liver, fused portal and hepatic veins, and partially fused intestines. Patient B appeared with complications of pentalogy of Fallot (PoF). The patient also had polycythemia (hemoglobin 14.7 g/dL, hematocrit 50%). Radiological features showed anterior abdominal wall with images of interconnected intestinal system between the two. In thoracoabdominopagus conjoined twins, the possibility of shared circulation becomes important especially associated with injection of intravenous drugs. The goal of anesthesia in PoF is to maintain cardiac output by maintaining heart rate, contractility and preload; and preventing right to left shunting via ventricular septal defect (VSD). Induction can cause vasodilation and the resultant decrease in systemic vascular resistance (SVR) can exacerbate right-to-left shunts. Monitoring end tidal CO2 (EtCO2) is needed. We present a report of anesthesia for such a case. Abbreviations: ASD: Atrial Septal Defect; PoF: Pentalogy of Fallot; VSD: Ventricular Septal Defect; SVR: Systemic Vascular Resistance Key words: Conjoined Twins; Pentalogy of Fallot; Congenital Heart Disease; Cyanosis; Anesthesia Citation: Purwoko, Santosa SB, Novianto B, Ganitafuri H. Anesthetic management of omphalopagus twins with pentalogy of Fallot undergoing separation surgery. Anaesth. pain intensive care 2023;27(3):434−440. DOI: 10.35975/apic.v27i3.2224 Received: May 24, 2022; Reviewed: Sep 18, 2022; Accepted: Jan 04, 2023

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Dicephalus dipus tetrabrachius conjoined twins of Zaria: Case report and literature review

Cited by 6 publications

References 6 publications

A Case of Ischiopagus Dicephalus Conjoined Twins with Tetrabrachius Bipus from Dessie, Ethiopia

A Case of Ischiopagus Dicephalus Conjoined Twins with Tetrabrachius Bipus from Dessie, Ethiopia

Znieczulenie bliźniąt syjamskich

Anesthetic management of omphalopagus twins with pentalogy of Fallot undergoing separation surgery

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