CC BY 4.0 · European J Pediatr Surg Rep. 2022; 10(01): e53-e62
DOI: 10.1055/s-0042-1743579
Case Report

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

1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Shaimaa A. Mohammad
2   Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
,
Ahmed B. Radwan
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Leila ElDieb
2   Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
,
Yasmin G. El-Gendy
3   Department of Pediatrics, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Hanan Ibrahim
3   Department of Pediatrics, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Akram Amer
4   Department of Anesthesia, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Tarek Shabana
4   Department of Anesthesia, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Hany Elzahaby
4   Department of Anesthesia, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Amir Elbarbary
5   Department of Plastic Surgery, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Mohamed Saleh
5   Department of Plastic Surgery, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Tarek H. Abdelaziz
6   Department of Orthopedics, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Shady Elbeshry
6   Department of Orthopedics, Ain Shams University Faculty of Medicine, Cairo, Egypt
,
Sameh Abdel-Hay
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
,
Alaa El-Ghoneimi
7   Department of Pediatric Surgery and Urology, Robert-Debré Mother-Child University Hospital, Paris, Île-de-France, France
,
Ahmad Zaki
1   Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
› Author Affiliations
Funding None.

Abstract

Conjoined 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.



Publication History

Received: 23 October 2021

Accepted: 13 January 2022

Article published online:
10 March 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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