Epigastric Heteropagus Conjoined Twin – A Case Report
Aminu Muhammed Umar
Consultant Paediatric Surgeon, Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
Kefas John Bwala
Consultant Paediatric Surgeon, Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
Makama Baje Salihu
Consultant Urologists, Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
Aminu Muhammed
Professor/Consultant Paediatric Surgeon, Department of Surgery, Aminu Kano University Teaching Hospital/Bayero University, Kano, Kano State, Nigeria
Stephen Yusuf
Senior Registrar, Department of Orthopaedic Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria
Abstract:
Background: Conjoined twins are babies attached to each other at some point. They occur in 1 in about every 200,000 live births and may be described as Symmetric (Diplopagus) or Asymmetric (Heteropagus). Heteropagus refers to conjoined twins where an apparently normal twin- the autosite- has attached to it an incomplete member- the parasite- and are exceedingly rare with a worldwide incidence of about 1 in 1-2 million births. The form of these heteropagus twins in which the parasite is attached to the epigastric region of the host referred to as epigastricheteropagus is even rarer. Case report: Here we report a day-old female neonate delivered by Spontaneous Vertex Delivery in a Primary Health Centre to a 20year old P3+0 3A with a parasite attached at the epigastric region. The parasite comprised a trunk to which two identifiable lower limbs were attached, with a single stalk attached to its upper pole from which two hands with identifiable digits arose. There was also a coexisting omphalocoele in an otherwise normal autosite. Abdominal USS and CT scan showed a single liver with no major connection between the babies, Intravenous Urogram confirmed the presence of two kidneys normal in position and excretion with normal collecting system within the autosite and none in the parasite. Doppler USS of the stalk eliminated major vascular connection between the two. Separation was successfully done at 2 months of life and patient did well postoperatively. Child is currently five (5) years old and growth and development proceeding normally. Conclusion: Epigastric heteropagus twins require multidisciplinary approach; careful planning and separation plan individualized according to the need of emergent separation and degree of organ fusion.
Published in: International Journal of Recent Advances in Multidisciplinary Topics (Volume 5, Issue 10, October 2024)
Page(s): 7-9
Date of Publication: 05/10/2024
Publisher: IJRAMT
Cite as:
Aminu Muhammed Umar, Kefas John Bwala, Makama Baje Salihu, Aminu Muhammed, Stephen Yusuf, “Epigastric Heteropagus Conjoined Twin – A Case Report,” in International Journal of Recent Advances in Multidisciplinary Topics, vol. 5, no. 10, pp. 7-9, October 2024.