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

Amr A. AbouZeid; Shaimaa A. Mohammad; Ahmed B. Radwan; Leila ElDieb; Yasmin G. El-Gendy; Hanan Ibrahim; Akram Amer; Tarek Shabana; Hany Elzahaby; Amir Elbarbary; Mohamed Saleh; Tarek H. Abdelaziz; Shady Elbeshry; Sameh Abdel-Hay; Alaa El-Ghoneimi; Ahmad Zaki

doi:10.1055/s-0042-1743579

European Journal of Pediatric Surgery Reports, Inhaltsverzeichnis

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

Autoren

Amr A. AbouZeid

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

²Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
Ahmed B. Radwan

¹Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
Leila ElDieb

²Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt
Yasmin G. El-Gendy

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

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

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

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

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

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

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

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

⁶Department of Orthopedics, Ain Shams University Faculty of Medicine, Cairo, Egypt
Sameh Abdel-Hay

¹Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt
Alaa El-Ghoneimi

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

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

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.

Keywords

congenital - penile anomalies - abdominal wall defect - continence - imperforate anus

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Referenzen

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