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Left over bowels: an unique complication in a surviving twin
A T George1, S Varkey, A Kalam
1Department of General Surgery, Medical College Hospital, Thiruvananthapuram, Kerala State, India. anilthomasgeorge@hotmail.com
Postgraduate Medical Journal
|December 8, 2004
Summary
This case report details an unusual finding in a surviving epigastric heteropagus twin: a duplicated large bowel and accessory liver. These congenital anomalies were asymptomatic for 17 years.
Area of Science:
- Medical Case Reports
- Surgical Pathology
- Congenital Anomalies
Background:
- Conjoint twins present significant surgical challenges.
- Epigastric heteropagus twins involve parasitic components attached to the autosite's abdomen.
- Surgical management aims to separate conjoined twins and address associated anomalies.
Observation:
- A 17-year-old male presented with acute intestinal obstruction.
- Laparotomy revealed a complete, blind-ending duplication of the large bowel.
- An accessory liver in the falciform ligament and a separate gallbladder with fused bile ducts were also noted.
Findings:
- The duplicated bowel and accessory liver are presumed remnants of an incompletely developed parasitic twin.
- These structures were assimilated into the autosite's anatomy.
- The patient remained asymptomatic for 17 years despite these congenital anomalies.
Implications:
- This case highlights the complex anatomical variations possible in conjoint twins.
- It underscores the potential for asymptomatic assimilation of parasitic twin remnants.
- The findings contribute to understanding the spectrum of congenital anomalies in heteropagus twins.