Epigastric heteropagus twins: 3 case reports with review of literature

Bizarre Presentation of Epigastric Heteropagus: Report of a Case

“…Epigastric heteropagus refers to conjoined twins, in which the parasite is attached to the epigastrium of the autosite. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] After incomplete cleavage of the embryo, ischemic changes of varying degree occur and the remaining parasite usually has a rudimentary upper part of the body. Some reports describe a parasite connected at the chest wall as a result of a giant omphalocele, but they were still usually classified as epigastric heteropagus.…”

“…To our knowledge, only 27 cases have been reported in the English literature. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In some cases, the parasite was attached to the chest wall of the autosite, but these cases were still categorized as epigastric heteropagus. 2,7,12,13 In epigastric heteropagus, the parasite usually has a rudimentary upper part of the body, a pelvic bone, visceral organs such as a bladder, kidney, genitourinary organs, gastrointestinal tract, and lower limbs, but the pattern of abnormalities differs from that in caudal duplication (dipygus).…”

Heteropagus (parasitic) twins: a review

“…Ethnicity, which may be a risk factor for heteropagus twins, is inconsistently reported. However, review of the literature dating back to the 1940s suggests that India is the country of origin in 29% of cases [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and South Africa in 16% of cases [13,30,31]. These figures may reflect reporting patterns rather than true incidence.…”

“…Separation is warranted based not only on cosmetic and psychosocial grounds but also because parasites often cause respiratory distress and may restrict growth of autosites [28,40,51,57].…”

Epigastric Heteropagus Twins: A Case Report

“…The prognosis and outcome of the separation of the twins depends on the extent of visceras they share and other anomalies. However, early diagnosis, intensive prenatal management and proper route of delivery are vital for the successful treatment of EHT patients [10].…”