Successful separation of xypho-omphalopagus conjoined twins with extrauterine twin-twin transfusion syndrome: a case report

Abstract

Conjoined twining is a rare medical phenomenon, with an overall prevalence of 1.47 per 100 000 births. This report describes a successful separation of xypho-omphalopagus conjoined twins complicated by unbalanced blood shunting through the porto-systemic anastomoses within the shared liver parenchyma. Significant extrauterine twin-twin transfusion syndrome caused by unbalanced shunting is an extremely rare, and probably under-recognized, hemodynamic complication in conjoined twins necessitating urgent separation. Progressive deterioration with a poor outcome can be prevented if the condition is recognized in a timely manner.

A successful separation of omphalopagus twins during COVID-19 pandemic: A case report

“…Thoracopagus has a conjunction of the heart, while omphalopagus refers to those with separate hearts (Osmanağaoğlu et al, 2011). These differences define the prognosis and treatment, in which thoracopagus are almost inseparable (Grizelj et al, 2019).…”

Successful emergency separation of premature omphalopagus conjoined twins: an anaesthetic experience

“…TA developed CT extrauterine transfusion syndrome, with anuria despite creatinine levels within normal limits. 5 Despite the usual occurrence of vascular shunts and cross-circulation in CT, only a few cases of haemodynamically significant unbalanced circulatory shunting have been reported. 5 The extent of shared vasculature affects drug pharmacokinetics and pharmacodynamics, as well as fluid and blood administration.…”

“…5 Despite the usual occurrence of vascular shunts and cross-circulation in CT, only a few cases of haemodynamically significant unbalanced circulatory shunting have been reported. 5 The extent of shared vasculature affects drug pharmacokinetics and pharmacodynamics, as well as fluid and blood administration. Prior to completion of surgical separation, CVP in TA was maintained at 5-6 mmHg to minimize cross-circulation to TB.…”

A case of successful treatment and separation of conjoined twins in Croatia!

“…Conjoined twining is a very rare congenital malformation, which may appear in many different morphological forms. Some of the twins may die in utero , after miscarriage or induced abortion, and some may die after birth or later (1). Some, however, may lead a long and fruitful life, especially those who were successfully separated.…”

“…The case report by Grizelj et al on a successful separation of conjoined twins at the University Hospital Center Zagreb (1), published in this issue of Croatian Medical Journal, is both an exciting medical story and evidence of an important success of Croatian medicine. The authors clearly describe the entire diagnostic and treatment process: they recognized conjoined twin fetuses early in the 11th week of gestation, followed them through pregnancy, and confirmed their findings with magnetic resonance imaging (1). When the diagnosis was definite, the health care team in charge of prenatal and postnatal care had enough time to prepare for treatment after delivery.…”