Home Ahead of print Instructions
About us Current issue Subscribe
Editorial board Archives Contact us
Search Submit article Login 
Print this page Email this page
ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 92-97

Management of conjoined twins in Kano, Nigeria: our experience and challenges in a low-resource setting


1 Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Anaesthesia, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
3 Department of Surgery, Murtala Mohammad Specialist Hospital, Kano, Nigeria
4 Department of Paeditrics, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
5 Department of Radiology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
Dr. Mohammad Aminu Mohammad
Paediatric Surgery Unit, Department of Surgery, Bayero University/Aminu Kano Teaching Hospital, Kano
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_16_16

Rights and Permissions

Introduction: Conjoined twins are abnormalities of twinning in which two individuals are incompletely separated. Conjoined twins can be symmetric or asymmetric and continue to raise significant ethical and legal arguments, resulting in much pressure on the managing teams and hospitals. Patients and Methods: We report 4 cases of conjoined twins, an ischiophagus dipus, pygophagus, thoracoomphalophagus tetrapus, and a parasitic twin tripus. All cases had no prenatal diagnosis and were delivered via spontaneous vaginal delivery. The pygophagus tetrapus was separated and a mortality of 50% was recorded in the immediate post separation period; the surviving twin is 8 years old and doing well. Two were lost due to severe birth trauma, and the last was lost to overwhelming from an infected gluteal congenital defect. Results and Discussion: Conjoined twins are one of the most fascinating congenital malformations not only to the medical practitioners but to communities and general public also. To our knowledge, as of 2012, only 15 cases have been reported from Nigeria. The incidence is 1:50,000–1:100,000 births. Females are affected more frequently than males by a ratio of 3:1. Separation of conjoined twins is a complicated procedure. The importance of a multidisciplinary team approach with several rehearsals of all aspects (surgical, anesthetic intensive care, transfer from the theatre to intensive care unit, and nursing) of the operative procedure cannot be overemphasized. Conclusion: Conjoined twins are one of the most fascinating congenital malformations. Early prenatal diagnosis, antenatal care, choice of mode of delivery, thorough assessment of the extent of shared organs to guide decisions on surgical separation, adequate planning, and rehearsals can reduce morbidity and mortality in these patients. In our series, all pregnancies and deliveries were unsupervised leading to poor outcome.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2627    
    Printed98    
    Emailed0    
    PDF Downloaded201    
    Comments [Add]    
    Cited by others 1    

Recommend this journal