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Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports
Conjoined twins are derived from the division of a single fertilized ovum; a phenomenon accompanied with multiple congenital anomalies. Such twins are identical, of the same sex, and more likely to be female. Most twins die during the embryonic period, and only 18% survive longer than 24 hours. Ther...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Shiraz University of Medical Sciences
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071550/ https://www.ncbi.nlm.nih.gov/pubmed/32210492 http://dx.doi.org/10.30476/ijms.2019.81060. |
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author | Bahador, Ali Nikeghbalain, Saman Foroughi, Mehdi Beizavi, Zahra Sahmeddini, Mohammad Ali Eghbal, Mohammad Hossein Vafaei, Homeira Malekhosseini, Seyyed Ali Bahador, Mohsen |
author_facet | Bahador, Ali Nikeghbalain, Saman Foroughi, Mehdi Beizavi, Zahra Sahmeddini, Mohammad Ali Eghbal, Mohammad Hossein Vafaei, Homeira Malekhosseini, Seyyed Ali Bahador, Mohsen |
author_sort | Bahador, Ali |
collection | PubMed |
description | Conjoined twins are derived from the division of a single fertilized ovum; a phenomenon accompanied with multiple congenital anomalies. Such twins are identical, of the same sex, and more likely to be female. Most twins die during the embryonic period, and only 18% survive longer than 24 hours. There are complex anomalies in thoraco-omphalopagus twins that makes them unlikely to live long enough to undergo separation. Treatment of this uncommon condition presents both surgical and anesthetic challenges. The management of rare anomalies is difficult even for skilled surgeons. Therefore, it is logical to use the knowledge gained from previous experiences. We herein present the first successful surgical separation of two pairs of thoraco-omphalopagus conjoined twins at the Pediatric Surgery Center of Namazi Hospital (Shiraz, Iran). In both cases, the neonates had separate hearts and common pericardium. Contrast-enhanced computed tomography of two sets of twins showed fusion of sternum, pericardium, diaphragm, and left lobe of liver. Critical steps of the surgical separation were identified and contingency plans were made for possible partial liver donation and cross-circulation between twins. The separation procedure and reconstruction of the abdominal wall were successfully performed. Both pairs of twins, now 6- and 8-year-old, are healthy and have normal growth and are under follow-up. |
format | Online Article Text |
id | pubmed-7071550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Shiraz University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-70715502020-03-24 Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports Bahador, Ali Nikeghbalain, Saman Foroughi, Mehdi Beizavi, Zahra Sahmeddini, Mohammad Ali Eghbal, Mohammad Hossein Vafaei, Homeira Malekhosseini, Seyyed Ali Bahador, Mohsen Iran J Med Sci Case Report Conjoined twins are derived from the division of a single fertilized ovum; a phenomenon accompanied with multiple congenital anomalies. Such twins are identical, of the same sex, and more likely to be female. Most twins die during the embryonic period, and only 18% survive longer than 24 hours. There are complex anomalies in thoraco-omphalopagus twins that makes them unlikely to live long enough to undergo separation. Treatment of this uncommon condition presents both surgical and anesthetic challenges. The management of rare anomalies is difficult even for skilled surgeons. Therefore, it is logical to use the knowledge gained from previous experiences. We herein present the first successful surgical separation of two pairs of thoraco-omphalopagus conjoined twins at the Pediatric Surgery Center of Namazi Hospital (Shiraz, Iran). In both cases, the neonates had separate hearts and common pericardium. Contrast-enhanced computed tomography of two sets of twins showed fusion of sternum, pericardium, diaphragm, and left lobe of liver. Critical steps of the surgical separation were identified and contingency plans were made for possible partial liver donation and cross-circulation between twins. The separation procedure and reconstruction of the abdominal wall were successfully performed. Both pairs of twins, now 6- and 8-year-old, are healthy and have normal growth and are under follow-up. Shiraz University of Medical Sciences 2020-03 /pmc/articles/PMC7071550/ /pubmed/32210492 http://dx.doi.org/10.30476/ijms.2019.81060. Text en Copyright: © Iranian Journal of Medical Sciences https://creativecommons.org/licenses/by-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Bahador, Ali Nikeghbalain, Saman Foroughi, Mehdi Beizavi, Zahra Sahmeddini, Mohammad Ali Eghbal, Mohammad Hossein Vafaei, Homeira Malekhosseini, Seyyed Ali Bahador, Mohsen Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title | Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title_full | Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title_fullStr | Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title_full_unstemmed | Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title_short | Successful Surgical Separation of Thoraco-Omphalopagus Symmetrical Conjoined Twins in Iran: Two Case Reports |
title_sort | successful surgical separation of thoraco-omphalopagus symmetrical conjoined twins in iran: two case reports |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071550/ https://www.ncbi.nlm.nih.gov/pubmed/32210492 http://dx.doi.org/10.30476/ijms.2019.81060. |
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