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Surgery of conjoined twins
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Lewis Spitz, Edward M. Kiely, Agostino Pierro
The earliest example of conjoined twins is a 17 cm marble statuette portraying parapagus twins, “the double goddess,” dating from the sixth millennium bce. The statue of the sisters of Catathoyuk is in the collection of the Anatolian Civilization Museum in Ankara, Turkey. Another early example is a stone carving of pygopagus twins dated to 80 bc in the St Marco Museum, Florence, Italy. The earliest attempt at separation of conjoined twins occurred in Kappadokia, Armenia, in ad 970. When one of the male ischiopagus twins died, aged 30 years, an attempt was made to save the surviving twin by separating him from his dead brother, but he died 3 days later.
Conjoined twins
Published in Prem Puri, Newborn Surgery, 2017
Juan A. Tovar, Leopoldo Martinez
Symmetric conjoined twins may be joined by the head (craniopagus), the thorax (thoracopagus), the abdomen (omphalopagus), the spine (rachiopagus), or the caudal pole (ischiopagus and pygopagus). Occasionally, they are laterally fused along the body axis (parapagus).23–25
From ‘monstrous’ to ‘abnormal’
Published in Waltraud Ernst, Histories of the Normal and the Abnormal, 2006
A cursory title search of the medical periodical literature in the United States and Britain between 1800 and 1910 reveals that forms of the term ‘monster’ were used frequently throughout the period. The greatest use occurred between 1870 and 1890.54 A number of other, descriptive terms, such as lusus naturae and variations on the phrases ‘united twins’, ‘joined twins’, ‘double’ or ‘duplex twins’ as well as ‘Siamese twins’, were used synonymously. At first the latter term was used specifically to refer to Chang and Eng, the ‘original’ Siamese twins; later it was frequently applied to other pairs of twins joined in a similar manner, although it never replaced variations of the word ‘monstrosity’.55 The first reference to ‘conjoined twins’ that I have found appeared in 1861, with the term ‘abnormal’ following in 1875.56 In the 1880s, terms that denoted increasing scientific classification, including location and degree of connection, began to appear regularly. Several of these end with the Greek suffix pagus which means ‘fastened’, and are still used today. The prefix refers to the manner in which they were fastened. ‘Pygopagus’ twins, for example, were joined at the coccyx and sacrum. ‘Ischiopagus’ twins were joined at the backbone and sacrum. This new level of detail is indicative of the efforts of the medical profession to bring order, through increasingly specific classificatory terms, to their understanding of unusual anatomies. According to the American doctor J. W. Ballantyne, this change in naming ways demonstrated the extent to which by the turn from the nineteenth to the twentieth century teratology as a science had become international in scope. However, he conceded that these terms were ‘uncouth and unfamiliar to the eye and ear of the Englishspeaking medical man’ and that ‘it would be easier to give the various monstrosities English names’, thus enabling people to ‘speak of a double-headed twin monster, or of a brainless fetus, or of a one-eyed monstrosity’.57 These ‘designations’, he asserted, would be more easily understood by us than such names as dicephalus, anen-cephalus … but to scientists of other nationalities their meaning might not be plain. So it has come about, for the sake of international convenience, Greek words have been made use of to found a teratological nomenclature.58
Antenatal diagnosis of thoracopagus conjoined twins with single heart and liver: a case report
Published in Journal of Obstetrics and Gynaecology, 2020
Conjoined twins were classified by Spencer (1996) and are named according to the most prominent site of fusion. The conjoined site may be in the ventral, dorsal or lateral groups. There are four types in the ventral group: cephalopagus (head), thoracopagus (chest), omphalopagus (umbilicus) and the ischiopagus (hip). The dorsal group includes three types: pygopagus (sacrum), rachipagus (spine) and the craniopagus (cranium). The lateral group defines parapagus (lateral) conjoined twins. Although the most common type is thoracopagus, it is difficult to treat conjoined twins due to shared cardiac formations (Tannuri et al. 2013). Nowadays, the diagnosis of conjoined twins is often done by ultrasound imaging, which is performed in the second trimester. Magnetic resonance imaging may play an important role in identifying the shared organs (Alkhateeb et al. 2015). After the diagnosis, counselling is provided to family and options are offered. These options include termination of pregnancy, selective fetocide and postpartum surgical separation. In this study, we present an extremely rare case of thoracopagus conjoined twins who shareds one heart and one liver.
Conjoined twins—early prenatal diagnosis
Published in Journal of Obstetrics and Gynaecology, 2020
Nicolae Gica, Nicoleta Gana, Corina Mat, Anca Maria Panaitescu, Gheorghe Peltecu, Ana Maria Vayna
According to the shared anatomy, the conjoined twins are classified into: thoracopagus (42%), parapagus dicephalus (11.6%), cefalopagus (5.5%), omfalopagus (5.5%), parasitic (3.9%), craniopagus (3.4%), parapagus diprosopus (2.9%), ischiopagus (1.8%), rachipagus (1.0%), piopagus (1.0%) and unspecified (21.4%) (Mutchinick et al. 2011).