We present the anaesthetic management during the colostomy opening in omphalopagus
twins and ultrasound-guided (UG) central venous catheterisation (CVC).
twins, those who are connected at the belly and liver, are some of the most complex to separate.
They are further classified into eight basic types relative to their site(s) of union or pagus (Greek for joined): Omphalopagus
(umbilicus/abdomen), thoracopagus (thorax/upper abdomen), cephalopagus (maxillofacial), craniopagus (skull), ischiopagus (pelvis), rachipagus (spine) and pygopagus (sacrum).
Langer, "The use of Surgisis[R] for abdominal wall reconstruction in the separation of omphalopagus
conjoined twins," Pediatric Surgery International, vol.
Every report on omphalopagus
twins should begin in deference to Chang and Eng, the original Siamese twins, who were born in 1811 and lived to the age of 63.
Caption: Figure 2: Omphalopagus
twins delivered at Tercha General Hospital (the photo is taken at NICU after the death of the second born baby (left)).
Unusual cardiac malformations in conjoined twins: thoracopagus twins with conjoined pentalogy of Cantrell and an omphalopagus
twin with atretic ventricles.
Dagupan City, Pangasinan -- A mother of conjoined twins, joined in their umbilical regions (omphalopagus
) who are now one-month-old, has appealed to authorities to help her with the operation for her twins for them to have a normal life.
Conjoined twins represent an uncommon congenital malformation, with an estimated incidence of 1: 50,000-1: 100,000,1 and approximate 75 Percent of cases are females.2,3 Usually, conjoined twins are classified according to the most prominent site of conjunction: thorax (thoracopagus) 40 Percent , abdomen (xiphopagus and omphalopagus
) 33 Percent , sacrum (pygopagus) 18 Percent , pelvis (ischiopagus) 6 Percent , and craniopagus (1-2 Percent).3,4
: Accounting for 33% of all conjoinings, this occurs when twins are attached at the abdomen.
The more common types of conjoined twins include the thoracopagus type where the fusion is anterior, at the chest, and involves the heart (35%); the omphalopagus
type where the fusion is at the mid-trunk (30%); the pygopagus type where there is a posterior union involving the rump (19%); the parapagus type, with a lateral fusion of the lower half of the body extending upwards (5%); and combination types.