Left over bowels: an unique complication in a surviving twin

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.