[A rare case of epigastric heteropagus twinning]

Epigastric heteropagus is a very rare form of conjoined twins. It results from an ischemic atrophy of the body structure of the monozygotic conjoined twins at an early gestational age. Diagnosis is made by prenatal echography which must look for congenital heart disease associated in 28% of epigastric heteropagus. Cesarean section is indicated to prevent for mechanical dystocia. The autosite component of epigastric heteropagus can successfully be treated with early minor surgery. Autosite twin survival is good. Discussion with the family is important to avoid needless terminations. We report a rare prenatal diagnosis of epigastric parasitic twinning in which the parasite had pelvis with lower limbs. At birth, the autosite had omphalocele containing only bowel loops from the parasite.