Thoracopagus parasitic twin with omphalocele rupture: a case report

Made Indah Pradnya Paramita; I Made  Kardana; Made  Sukmawati; Putu Junara  Putra; I Wayan Dharma  Artana

doi:10.15562/ism.v14i1.1661

Thoracopagus parasitic twin with omphalocele rupture: a case report

Made Indah Pradnya Paramita ,

I Made Kardana ,

Made Sukmawati ,

Putu Junara Putra ,

I Wayan Dharma Artana ,

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DOI: https://doi.org/10.15562/ism.v14i1.1661 |
Published: 2023-05-08

Abstract

Background: Heteropagus or parasitic twin is a rare congenital anomaly that affects two connected children with imprecisely understood anatomy and physiology. This case report aims to describe a thoracopagus patient with severe complications.

Case presentation: One-day-old female baby was born with thoracopagus and omphalocele rupture. She was the third child, born aterm from a 36-year-old mother, with a birth weight of 3000 grams. Laboratory and radiography examinations showed leukocytosis, metabolic acidosis, prolonged coagulation profile, acute kidney injury, hypoglycemia, transaminitis, and congenital heart defects. She was treated in the intensive care unit and managed conservatively. Unfortunately, she died on the sixth day of treatment due to severe complications.

Conclusion: Conjoined twins have a poor prognosis. If it is coupled with other congenital anomalies, it will worsen the outcome.

References

Mathur P, Sharma S, Mittal P, Yadav R, Barolia D. Heteropagus twins: six cases with systematic review and embryological insights. Pediatr Surg Int. 2022;
Sharma G, Mobin SSN, Lypka M, Urata M. Heteropagus (parasitic) twins: a review. J Pediatr Surg. 2010;45(12):2454–63. Available from: http://dx.doi.org/10.1016/j.jpedsurg.2010.07.002
Dejene B, Negash SA, Mammo TN, Tadesse A, Getachew H, Derbew M. Heteropagus (parasitic) twins. J Pediatr Surg Case Reports. 2018;37:44–9. Available from: http://dx.doi.org/10.1016/j.epsc.2018.07.019
Ramlan AAW, Zahra R, Rinaldhy K, Kapuangan C, Rahendra, Ferdiana KA, et al. Emergency separation of conjoined twins in a tertiary hospital in Indonesia: three case reports. BMC Med Ethics. 2023;24(1):16. Available from: https://pubmed.ncbi.nlm.nih.gov/36829194
Abakar Djibrine M, Ngaringuem O, Djidita Hagré Y, Adam A, Attimer K, Choua O. Heteropagus conjoined twins: Five cases. J Pediatr Surg Case Reports. 2022;76:102086. Available from: http://dx.doi.org/10.1016/j.epsc.2021.102086
Kaufman MH. The embryology of conjoined twins. Child's Nerv Syst. 2004;20(8–9). Available from: http://dx.doi.org/10.1007/s00381-004-0985-4
Kamalian N, Shirani S, Soleymanzadeh M. Thoraco- Omphalo-Ischiopagus Tripus Conjoined Twins: Report of a Case. J Forensic Res. 2011;02(01). Available from: http://dx.doi.org/10.4172/2157-7145.1000117
Alves R de CS, Petry AUS, Marçal JMB, Hochhegger B, Damin AS, Roehe AV. Asymmetric parasitic twins - Heteropagus. Rev Assoc Med Bras. 2020;66(11):1526–9. Available from: http://dx.doi.org/10.1590/1806-9282.66.11.1526
Giovanna R, Daniela B, Giovanni P, Angela M. Thoracopagus Conjoined Twins: Early Diagnosis by Ultrasound, A Case Report. Clin Med Rev Case Reports. 2020;7(4). Available from: http://dx.doi.org/10.23937/2378-3656/1410305
Collins RT, O'Connor MJ. The Outcomes of Surgical Separation in Thoracopagus Twins with Conjoined Hearts: An Analysis of the Literature. Pediatr Cardiol. 2021;42(4):875–82. Available from: http://dx.doi.org/10.1007/s00246-021-02555-8
Gonzalez KW, Chandler NM. Ruptured omphalocele: Diagnosis and management. Semin Pediatr Surg. 2019;28(2):101–5. Available from: http://dx.doi.org/10.1053/j.sempedsurg.2019.04.009
Brizot ML ML, Liao AW, Lopes LM, Okumura M, Marques MS, Krebs V, et al. Conjoined twins pregnancies: experience with 36 cases from a single center. Prenat Diagn. 2011;n/a-n/a. Available from: http://dx.doi.org/10.1002/pd.2843

[1] Mathur P, Sharma S, Mittal P, Yadav R, Barolia D. Heteropagus twins: six cases with systematic review and embryological insights. Pediatr Surg Int. 2022;

[2] Sharma G, Mobin SSN, Lypka M, Urata M. Heteropagus (parasitic) twins: a review. J Pediatr Surg. 2010;45(12):2454–63. Available from: http://dx.doi.org/10.1016/j.jpedsurg.2010.07.002

[3] Dejene B, Negash SA, Mammo TN, Tadesse A, Getachew H, Derbew M. Heteropagus (parasitic) twins. J Pediatr Surg Case Reports. 2018;37:44–9. Available from: http://dx.doi.org/10.1016/j.epsc.2018.07.019

[4] Ramlan AAW, Zahra R, Rinaldhy K, Kapuangan C, Rahendra, Ferdiana KA, et al. Emergency separation of conjoined twins in a tertiary hospital in Indonesia: three case reports. BMC Med Ethics. 2023;24(1):16. Available from: https://pubmed.ncbi.nlm.nih.gov/36829194

[5] Abakar Djibrine M, Ngaringuem O, Djidita Hagré Y, Adam A, Attimer K, Choua O. Heteropagus conjoined twins: Five cases. J Pediatr Surg Case Reports. 2022;76:102086. Available from: http://dx.doi.org/10.1016/j.epsc.2021.102086

[6] Kaufman MH. The embryology of conjoined twins. Child's Nerv Syst. 2004;20(8–9). Available from: http://dx.doi.org/10.1007/s00381-004-0985-4

[7] Kamalian N, Shirani S, Soleymanzadeh M. Thoraco- Omphalo-Ischiopagus Tripus Conjoined Twins: Report of a Case. J Forensic Res. 2011;02(01). Available from: http://dx.doi.org/10.4172/2157-7145.1000117

[8] Alves R de CS, Petry AUS, Marçal JMB, Hochhegger B, Damin AS, Roehe AV. Asymmetric parasitic twins - Heteropagus. Rev Assoc Med Bras. 2020;66(11):1526–9. Available from: http://dx.doi.org/10.1590/1806-9282.66.11.1526

[9] Giovanna R, Daniela B, Giovanni P, Angela M. Thoracopagus Conjoined Twins: Early Diagnosis by Ultrasound, A Case Report. Clin Med Rev Case Reports. 2020;7(4). Available from: http://dx.doi.org/10.23937/2378-3656/1410305

[10] Collins RT, O'Connor MJ. The Outcomes of Surgical Separation in Thoracopagus Twins with Conjoined Hearts: An Analysis of the Literature. Pediatr Cardiol. 2021;42(4):875–82. Available from: http://dx.doi.org/10.1007/s00246-021-02555-8

[11] Gonzalez KW, Chandler NM. Ruptured omphalocele: Diagnosis and management. Semin Pediatr Surg. 2019;28(2):101–5. Available from: http://dx.doi.org/10.1053/j.sempedsurg.2019.04.009

[12] Brizot ML ML, Liao AW, Lopes LM, Okumura M, Marques MS, Krebs V, et al. Conjoined twins pregnancies: experience with 36 cases from a single center. Prenat Diagn. 2011;n/a-n/a. Available from: http://dx.doi.org/10.1002/pd.2843

Thoracopagus parasitic twin with omphalocele rupture: a case report

Abstract

References

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