Anatomy of successfully separated thoracopagus-omphalopagus conjoined twins

Jess L Thompson, Abdallah E. Zarroug, Jane M S Matsumoto, Christopher R. Moir

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus- omphalopagus twins and their successful surgical separation. Preoperative radiologic imaging demonstrated that the twins did not share myocardium, but an ectopic cordis was present. The inferior vena cavae entered the right atria at more acute angles than normal. The liver was fused, two gallbladders were present, and there was a large bridging portal vein that crossed the hepatic isthmus of one twin to the conjoined twin's portal venous system. Replaced hepatic arteries originated from the superior mesenteric arteries. Each twin had separate kidneys, colons, and rectums. Preoperative tissue expansion was necessary, and the twins were separated at 51/2 months of life. Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.

Original languageEnglish (US)
Pages (from-to)814-818
Number of pages5
JournalClinical Anatomy
Volume20
Issue number7
DOIs
StatePublished - 2007
Externally publishedYes

Fingerprint

Conjoined Twins
Anatomy
Tissue Expansion
Portal System
Superior Mesenteric Artery
Liver
Hepatic Artery
Inferior Vena Cava
Portal Vein
Gallbladder
Heart Atria
Rectum
Myocardium
Colon
Parturition
Kidney

Keywords

  • Medical illustration
  • Pediatric surgery

ASJC Scopus subject areas

  • Anatomy

Cite this

Anatomy of successfully separated thoracopagus-omphalopagus conjoined twins. / Thompson, Jess L; Zarroug, Abdallah E.; Matsumoto, Jane M S; Moir, Christopher R.

In: Clinical Anatomy, Vol. 20, No. 7, 2007, p. 814-818.

Research output: Contribution to journalArticle

Thompson, Jess L ; Zarroug, Abdallah E. ; Matsumoto, Jane M S ; Moir, Christopher R. / Anatomy of successfully separated thoracopagus-omphalopagus conjoined twins. In: Clinical Anatomy. 2007 ; Vol. 20, No. 7. pp. 814-818.
@article{c06128ff17e34a1e867c080d59566f84,
title = "Anatomy of successfully separated thoracopagus-omphalopagus conjoined twins",
abstract = "The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus- omphalopagus twins and their successful surgical separation. Preoperative radiologic imaging demonstrated that the twins did not share myocardium, but an ectopic cordis was present. The inferior vena cavae entered the right atria at more acute angles than normal. The liver was fused, two gallbladders were present, and there was a large bridging portal vein that crossed the hepatic isthmus of one twin to the conjoined twin's portal venous system. Replaced hepatic arteries originated from the superior mesenteric arteries. Each twin had separate kidneys, colons, and rectums. Preoperative tissue expansion was necessary, and the twins were separated at 51/2 months of life. Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.",
keywords = "Medical illustration, Pediatric surgery",
author = "Thompson, {Jess L} and Zarroug, {Abdallah E.} and Matsumoto, {Jane M S} and Moir, {Christopher R.}",
year = "2007",
doi = "10.1002/ca.20514",
language = "English (US)",
volume = "20",
pages = "814--818",
journal = "Clinical Anatomy",
issn = "0897-3806",
publisher = "Wiley-Liss Inc.",
number = "7",

}

TY - JOUR

T1 - Anatomy of successfully separated thoracopagus-omphalopagus conjoined twins

AU - Thompson, Jess L

AU - Zarroug, Abdallah E.

AU - Matsumoto, Jane M S

AU - Moir, Christopher R.

PY - 2007

Y1 - 2007

N2 - The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus- omphalopagus twins and their successful surgical separation. Preoperative radiologic imaging demonstrated that the twins did not share myocardium, but an ectopic cordis was present. The inferior vena cavae entered the right atria at more acute angles than normal. The liver was fused, two gallbladders were present, and there was a large bridging portal vein that crossed the hepatic isthmus of one twin to the conjoined twin's portal venous system. Replaced hepatic arteries originated from the superior mesenteric arteries. Each twin had separate kidneys, colons, and rectums. Preoperative tissue expansion was necessary, and the twins were separated at 51/2 months of life. Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.

AB - The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus- omphalopagus twins and their successful surgical separation. Preoperative radiologic imaging demonstrated that the twins did not share myocardium, but an ectopic cordis was present. The inferior vena cavae entered the right atria at more acute angles than normal. The liver was fused, two gallbladders were present, and there was a large bridging portal vein that crossed the hepatic isthmus of one twin to the conjoined twin's portal venous system. Replaced hepatic arteries originated from the superior mesenteric arteries. Each twin had separate kidneys, colons, and rectums. Preoperative tissue expansion was necessary, and the twins were separated at 51/2 months of life. Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.

KW - Medical illustration

KW - Pediatric surgery

UR - http://www.scopus.com/inward/record.url?scp=35148820996&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35148820996&partnerID=8YFLogxK

U2 - 10.1002/ca.20514

DO - 10.1002/ca.20514

M3 - Article

C2 - 17583591

AN - SCOPUS:35148820996

VL - 20

SP - 814

EP - 818

JO - Clinical Anatomy

JF - Clinical Anatomy

SN - 0897-3806

IS - 7

ER -