Thoraco Omphalopagus Conjoined Twins
Thoraco omphalopagus conjoined twins ~ For thoraco omphalopagus conjoined twins the degree of fusion of the hepatobiliary and heart can pose surgical challenge. A rare case of thoraco omphalopagus ankur aneja 1 dayananda kumar rajanna 2 vikram narasimha reddy 3 kamala retnam mayilvavaganan 4 and poornima pujar 5 1 junior resident department of radiodiagnosis and modern imaging mv jayaram medical college and research hospital bangalore 562114 india. Conjoined twins also known as siamese twins are identical twins joined in utero an extremely rare phenomenon the occurrence is estimated to range from 1 in 49 000 births to 1 in 189 000 births with a somewhat higher incidence in southwest asia and africa.
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Prenatal diagnosis by ultrasound was established at 26 weeks gestation.
Thoraco omphalopagus conjoined twins. The most common form of conjoined twins is fusion of the anterior thorax and or abdomen referred to as thoracopagus omphalopagus and thoraco omphalopagus as in our case which altogether constitutes 70 of conjoined twins. 8 increased nuchal fold thickness has been documented in multiple cases of conjoined twins. Approximately half are stillborn and an additional one third die within 24 hours most live births are female with a ratio of 3 1. On arrival in our hospital at the first 21 h after the birth of the thoraco omphalopagus conjoined twins we performed the initial assessment with ultrasound and found that the twins shared the liver but had separate.
8 twin a and 7 twin b. Although omphalopagus twins have the best chances of survival adequate team management and preoperative planning is required. Conjoined twins are a rare congenital anomaly of twinning which borders on monstrosity. A recent theory postulates fusion of two embryonic discs as more of a cause for conjoined twinning than fission of a single embryonic plate.
The largest series reported includes 17 sets of twins by spitz et al. Symmetrical thoraco omphalopagus female conjoined twins were born in our institution by elective caesarean section at 34 weeks gestation with a combined weight of 4 2 kg. Of the various types of conjoined twins thoraco omphalopagus is a commonly occurring type. At 5 apgar scores were respectively.
The most common form of conjoined twins is fusion of the ante rior thorax and or abdomen referred to as thoracopagus ompha lopagus and thoraco omphalopagus as in our case which altogether constitutes 70 of conjoined twins 8 increased nuchal fold thicknesshasbeen documentedin multiplecases ofconjoined. 1 and 25 sets by cywes et al. The separation of conjoined twins presents a unique challenge to pediatric surgeons because of its rarity.
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