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Blastopathies--symmetrical conjoined twins

A D Kalgutkar1, V Pethe, S P Pandit

  • 1Lokmanya Tilak Municipal Medical College, Sion, Bombay.

Indian Journal of Pathology & Microbiology
|July 1, 1996
PubMed
Summary
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This report details two rare cases of conjoined twins in India, highlighting complex congenital anomalies and organ sharing. Successful surgical separation requires advanced prenatal diagnosis and meticulous post-operative care.

Area of Science:

  • Medical Science
  • Genetics
  • Pediatrics

Background:

  • Conjoined twins, a rare congenital anomaly, present significant medical challenges.
  • The incidence in India is approximately 1 in 60,000 pregnancies.
  • This report focuses on two challenging cases of female conjoined twins.

Observation:

  • The first case involved omphalopagus twins with fused gastrointestinal tracts, hypoplastic kidneys, and complex cardiac defects including dextrocardia, atrial septal defect (A.S.D.), and ventricular septal defect (V.S.D.).
  • The second case was thoracopagus twins with a fused liver, ventricular septal defect (V.S.D.), and a rare cardiac anomaly, cor triatrium dexter.
  • Both cases exhibited significant shared organ systems and complex congenital malformations.

Findings:

  • Omphalopagus twins presented with three lower extremities, a shared terminal ileum, crossed ectopia, hypoplastic kidneys, bicornuate uterus, dextrocardia, A.S.D., and V.S.D.

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  • Thoracopagus twins had a fused liver, V.S.D., and cor triatrium dexter with a posterior venous chamber.
  • Surgical separation was not attempted in the first case and was unsuccessful in the second.

    • Implications:

    • These cases underscore the critical need for early antenatal diagnosis of conjoined twins.
    • Successful surgical separation hinges on comprehensive pre- and post-operative management strategies.
    • Understanding complex anatomical variations is crucial for improving outcomes in conjoined twin cases.