Ventrally Fused Conjoined Twins (Omphaloischiopagus): A Roadmap to Successful Separation

Author:

AbouZeid Amr A.1ORCID,Mohammad Shaimaa A.2,Radwan Ahmed B.1,ElDieb Leila2,El-Gendy Yasmin G.3,Ibrahim Hanan3,Amer Akram4,Shabana Tarek4,Elzahaby Hany4,Elbarbary Amir5,Saleh Mohamed5,Abdelaziz Tarek H.6,Elbeshry Shady6,Abdel-Hay Sameh1,El-Ghoneimi Alaa7,Zaki Ahmad1

Affiliation:

1. Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt

2. Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt

3. Department of Pediatrics, Ain Shams University Faculty of Medicine, Cairo, Egypt

4. Department of Anesthesia, Ain Shams University Faculty of Medicine, Cairo, Egypt

5. Department of Plastic Surgery, Ain Shams University Faculty of Medicine, Cairo, Egypt

6. Department of Orthopedics, Ain Shams University Faculty of Medicine, Cairo, Egypt

7. Department of Pediatric Surgery and Urology, Robert-Debré Mother-Child University Hospital, Paris, Île-de-France, France

Abstract

AbstractConjoined twining is one of the most fascinating and challenging situations which a pediatric surgeon may face in his career. Only few surgeons may have the opportunity to share in separation of such cases. In this report, we aim to share our experience with the successful separation of ventrally fused male conjoined twins (omphaloischiopagus). The case was thoroughly studied via preoperative cross-sectional imaging modalities (magnetic resonance imaging [MRI] and computed tomography [CT] angiography), complemented by data obtained from reviewing similar cases in the literature. A clear delineation of the complex anatomy was achieved preoperatively which proved to be well consistent with the operative findings. A detailed description of the operative procedure to divide/redistribute the shared abdominal/pelvic organs between both twins is provided. To the best of our knowledge, this is the first report to describe the detailed and unique internal anatomy of a common central phallus associating ischiopagus conjoined twins. The penis was centrally located in the perineum in between both twins with an open urethral plate. This common phallus had a peculiar configuration with four crura anchoring ischial bones of both twins together.

Publisher

Georg Thieme Verlag KG

Subject

General Medicine

Reference21 articles.

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2. Imaging in the preoperative assessment of conjoined twins;C A Kingston;Radiographics,2001

3. Imaging of conjoined twins;K McHugh;Pediatr Radiol,2006

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