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Fetus-in-Fetu: A Tale of the Trapped Triplets

Ruchira Nandan1, Seth Kachhap1, Pratishtha Sengar2

  • 1Department of Pediatric Surgery, IMS-Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Journal of Indian Association of Pediatric Surgeons
|October 16, 2023
PubMed

Insights

A rare case of fetus-in-fetu (FIF) involved three fetuses within an abdominal sac in a newborn. One fetus presented a unique thoracic meningomyelocele, a previously unreported finding in FIF cases.

Area of Science:

  • Developmental biology
  • Pediatric surgery
  • Medical imaging

Background:

  • Fetus-in-fetu (FIF) is a rare congenital anomaly where a malformed fetus is found within the body of its twin.
  • This condition typically presents in infancy or childhood with non-specific symptoms related to mass effect.

Observation:

  • A 7-day-old infant presented with abdominal distention and jaundice.
  • Radiological imaging revealed an encapsulated retroperitoneal sac containing three fetus-in-fetu (FIF) specimens.
  • Surgical exploration confirmed a large abdominal sac compressing vital organs, including the duodenum and common bile duct.

Findings:

  • The encapsulated sac containing three FIFs was successfully excised intact.
  • One of the fetuses exhibited a highly differentiated form with a thoracic meningomyelocele.
  • This specific malformation (thoracic meningomyelocele) has not been previously documented in the literature for FIF cases.

Implications:

  • This case expands the known spectrum of malformations associated with fetus-in-fetu.
  • Highlights the importance of advanced imaging and surgical expertise in managing complex congenital anomalies.
  • Contributes to understanding the developmental processes and potential teratogenic factors involved in FIF.

Keywords:
Fetus-in-fetumeningomyeloceleobstructive jaundice

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