The conjoined twins of Shinyanga, Tanzania: case report

The first recorded set of conjoined twins in Tanzania was successfully separated on the 10th of February 1994 at the Muhimbili Medical Centre (MMC) in Dar es Salaam. The male omphalopagus twins were born to a 22-year-old para 1 gravida 2 mother by normal vaginal delivery at a Rural Health Centre in Shinyanga Region two months earlier, and had been transferred to the National Referral Hospital at the age of two weeks. At the age of about four months, the first twin died following multiple complications which necessitated several re-operations, while the second twin is still thriving and has been discharged to his home village since May 1994. This paper describes and discusses the medical, surgical and anaesthetic aspects of the management of these historic twins, and emphasizes the importance of teamwork in the evaluation, separation and care of such babies for a successful outcome. A brief review of the literature is also included, with special reference to the African experience.