Separation of ischiopagus tetrapus conjoined twins in the sultanate of oman

Freeman, N.V.; Fahr, Jutta; Al-Khusaiby, Saleh M.

doi:10.1007/bf01372144

Cited by 6 publications

(4 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…10 The best time to separate conjoined twins depends on anatomic and physiologic factors, and the recommendation age is between 2 to 12 months, except under emergent conditions. 10 Our second case is successfully separated at 6 months old and survived with normal development. It is highly possible to successfully separate conjoined twins in developing countries such as Indonesia, if the operation was being prepared and performed by dedicated and enthusiastic staff.…”

Section: Discussionmentioning

confidence: 99%

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Parapagus dicephalus conjoined twins and evaluation of ischiopagus tetrapus conjoined twins in Indonesia: a case report

Rochadi

2013

JMedScie

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Conjoined twins are rare occurrences in medical practice. In this study, two cases of conjoined twins, parapagus dicephalus and ischiopagus tetrapus are reported in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The first case i.e. five-day-old male parapagus dicephalus conjoined twins referred to the hospital. The twins have two heads, two arms and two legs. X-ray examination reveals two vertebrae collumn, single heart, and single pelvis. Moreover ultrasonography examination reveals conjoining of liver and echocardiography examinatin reveals single atrium. The twins were diagnosed as parapagus dicephalus. As a result of their fusion, operative care had been considered to be unacceptable. After several weeks in neonatal intensive care, they died. The second case i.e. two-day-old female conjoined twins with conjoining at ischium region referred to the hospital. Ultrasonography and abdominal examination reveal conjoining at intestinum, buttock and ischium. The twins was diagnsed as ischiopagus tetrapus. They were successfully separated at 6 months of age. They are alive and well so far for more than 7 years. In conclusion, the prognosis of conjoined twins is related to the type, extent of union and organ abnormalities. The successful separation of conjoined twins might be determined by good planning and staff enthusiasm and dedication. ABSTRAKBayi kembar siam adalah kejadian langkan di dunia kedokteran. Dalam makalah ini dilaporkan dua kasus bayi kembar siam yaitu parapagus dicephalus dan ischiopagus tetrapus di Rumah Sakit Umum Dr. Sardjito, Yogyakarta, Indonesia. Kasus I adalah bayi kembar siam laki-laki berumur lima hari dikirim ke rumah sakit. Bayi kembar siam tersebut mempunyai dua kepala, dua lengan dan dua kaki. Hasil pemeriksaan rontgen didapatkan dua kolumna vertebralis, satu jantung dan satu panggul. Selanjutnya hasil pemeriksaan ultrasonografi menunjukkan penyatuan liver sedangkan hasil pemeriksaan ekokardiografi menunjukkan satu atrium. Penderita didiagnosis sebagai parapagus dicephalus. Akibat penyatuan organ ini tindakan operasi tidak memungkinkan dilakukan. Setelah beberapa minggu dalam perawatan intensif, bayi kembar siam tersebut meninggal. Kasus II adalah bayi kembar siam perempuan berumur dua hari dengan penyatuan pada pantat dikirim ke rumah sakit. Hasil pemeriksaan ultrasonografi dan scanning abdomen menunjukkan adanya penyatuan pada usus, pantat, dan panggul. Penderita didiagnosis sebagai ischiopagus tetrapus. Operasi pemisahan berhasil dilakukan dengan baik pada umur 6 bulan. Mereka hidup sehat dan baik sejauh ini setelah tujuh tahun sejak dipisahkan. Dapat disimpulkan, prognosis kembar siam tergantung jenis dan tingkat penyatuan serta kelainan organ bayi. Keberhasilan pemisahan bayi kembar siam ditentukan oleh perencanaan operasi yang baik, dedikasi dan semangat tenaga medik dalam menjalankan tugasnya.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Parapagus dicephalus conjoined twins and evaluation of ischiopagus tetrapus conjoined twins in Indonesia: a case report

Rochadi

2013

JMedScie

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“…Most publications report technical aspects of ischiopagus separation with follow-up less than 2 years or do not specify the length of followup (e.g. [16][17][18][19][20]. Those that have significant follow-up, e.g.…”

Section: Discussionmentioning

confidence: 99%

The First Successful Lower Extremity Transplantation: 6-Year Follow-Up and Implications for Cortical Plasticity

Fattah

Cypel

Donner

et al. 2011

American Journal of Transplantation

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Vascularized composite allotransplantation as a viable reconstructive option is gaining recognition and new cases are being reported with increasing frequency including hand, face and laryngeal transplantation. However, only one successful complete lower limb transplantation has been reported to date, in which a functioning limb from one ischiopagus twin with a lethal cardiac anomaly was transplanted to the other. Six years later, the patient is mobilizing well and engaging in sporting activities with her peers in a mainstream school. Clinical evaluation of motor and sensory modalities demonstrated a good functional result. Quality of life was assessed using the short form-36 health survey and lower extremity functional scale disclosing a high level of social and physical capacity. Functional magnetic resonance imaging was performed and showed cortical integration of the limb; the implications of cortical plasticity and vascularized composite allotransplantation for the correction of congenital limb anomalies are presented.Key words: Conjoined twins, cortical plasticity, fMRI, lower extremity, vascularized composite allotransplantation Abbreviations: AFNI, analysis of functional neuroimages; BOLD, blood oxygen level dependent; FA, fractional anisotropy; fMRI, functional magnetic resonance imaging; FOV, field of view; FWHM, full width at half maximum; LEFS, lower extremity functional scale; MA,

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“…This affection is more common in females with sex ratio of 3:1. ( 1 , 2 ) Such patients are monozygotic and monochorionic twins. The incomplete separation of the inner cell mass around 13 to 15 days of gestation is responsible for this abnormality.…”

Section: Introductionmentioning

confidence: 99%

Late secondary urological reconstruction of separated ischiopagus twins with exstrophic bladder and urinary incontinence

Macedo¹,

Cruz²

2018

Einstein (São Paulo)

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We report a case of secondary urinary reconstruction of previously separated conjoined twins with exstrophic bladder and urinary incontinence. Patients were male and aged 13-year-old. Twin one had a history of failed enterocystoplasty that extruded and was visible like an exstrophic neobladder. He underwent a procedure to close bladder neck and reconfigure abdominal wall. After the procedure the patient developed a fistula that was treated, but it persisted and, for this reason, a catheterizable pouch was constructed and native bladder was discarded. Twin two required the immediately construction of catheterizable pouch using the Macedo’s technique. Currently, both patients are continent at 4 hour intervals. The mean follow-up was 8 months. Modern continent urinary diversion techniques offer new perspectives and hope for such complex population.

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Separation of ischiopagus tetrapus conjoined twins in the sultanate of oman

Cited by 6 publications

References 5 publications

Parapagus dicephalus conjoined twins and evaluation of ischiopagus tetrapus conjoined twins in Indonesia: a case report

Parapagus dicephalus conjoined twins and evaluation of ischiopagus tetrapus conjoined twins in Indonesia: a case report

The First Successful Lower Extremity Transplantation: 6-Year Follow-Up and Implications for Cortical Plasticity

Late secondary urological reconstruction of separated ischiopagus twins with exstrophic bladder and urinary incontinence

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