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Anaesthesia for the separation of conjoined twins.

Lalwani J, Dubey K, Shah P - Indian J Anaesth (2011)

Bottom Line: Thoraco-omphalopagus is one of the most common type of conjoint twins accounting for 74% cases of conjoint twins.We report the anaesthetic management for successful separation of thoraco-omphalopagus conjoint twins, both of them surviving till date.Detailed description of successful management is reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, PT.J.N.M. Medical College and Dr. Bram Hospital, Raipur, Chhattisgarh, India.

ABSTRACT
Thoraco-omphalopagus is one of the most common type of conjoint twins accounting for 74% cases of conjoint twins. We report the anaesthetic management for successful separation of thoraco-omphalopagus conjoint twins, both of them surviving till date. We highlight the responsibility of anaesthesia team in anaesthetising the two individual patients simultaneously, need of careful monitoring and anticipation of complications like massive blood loss, hypotension, hypokalemia, hypoxia and hypercabia. Detailed description of successful management is reported.

No MeSH data available.


Related in: MedlinePlus

Computerise Tomography scan
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Figure 0002: Computerise Tomography scan

Mentions: They were thoraco-omphalopagus twins, joined ventrally from the manubrium sterni to umbilicus [Figure 1]. For evaluation of the extent of shared organ systems the twins were anaesthetised twice before undergoing surgery, once for undergoing spiral computerized tomography (CT) scan with contrast at 15 days and magnetic resonance imaging (MRI) at 45 days of age. The twins were named R1 and R2 to avoid confusion. At each occasion separate intravenous (i.v.) lines were secured and i.v atropine (0.15 mg) and i.v midazolam was given for premedication to R1. No appreciable change was noticed in the level of consciousness in R2 suggesting little cross-circulation. R2 was also premedicated and i.v ketamine was given to both with oxygen supplementation by mask. CT scan revealed two separate livers in each baby with fused anterior surface [Figure 2]. Separate major hepatic veins were present in each liver with no major anastomosing vessels across the liver. Hearts, spleens, kidneys appeared independent and well functioning in both. MRI and ultasonography findings confirmed the findings of CT scan.


Anaesthesia for the separation of conjoined twins.

Lalwani J, Dubey K, Shah P - Indian J Anaesth (2011)

Computerise Tomography scan
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3106394&req=5

Figure 0002: Computerise Tomography scan
Mentions: They were thoraco-omphalopagus twins, joined ventrally from the manubrium sterni to umbilicus [Figure 1]. For evaluation of the extent of shared organ systems the twins were anaesthetised twice before undergoing surgery, once for undergoing spiral computerized tomography (CT) scan with contrast at 15 days and magnetic resonance imaging (MRI) at 45 days of age. The twins were named R1 and R2 to avoid confusion. At each occasion separate intravenous (i.v.) lines were secured and i.v atropine (0.15 mg) and i.v midazolam was given for premedication to R1. No appreciable change was noticed in the level of consciousness in R2 suggesting little cross-circulation. R2 was also premedicated and i.v ketamine was given to both with oxygen supplementation by mask. CT scan revealed two separate livers in each baby with fused anterior surface [Figure 2]. Separate major hepatic veins were present in each liver with no major anastomosing vessels across the liver. Hearts, spleens, kidneys appeared independent and well functioning in both. MRI and ultasonography findings confirmed the findings of CT scan.

Bottom Line: Thoraco-omphalopagus is one of the most common type of conjoint twins accounting for 74% cases of conjoint twins.We report the anaesthetic management for successful separation of thoraco-omphalopagus conjoint twins, both of them surviving till date.Detailed description of successful management is reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Critical Care, PT.J.N.M. Medical College and Dr. Bram Hospital, Raipur, Chhattisgarh, India.

ABSTRACT
Thoraco-omphalopagus is one of the most common type of conjoint twins accounting for 74% cases of conjoint twins. We report the anaesthetic management for successful separation of thoraco-omphalopagus conjoint twins, both of them surviving till date. We highlight the responsibility of anaesthesia team in anaesthetising the two individual patients simultaneously, need of careful monitoring and anticipation of complications like massive blood loss, hypotension, hypokalemia, hypoxia and hypercabia. Detailed description of successful management is reported.

No MeSH data available.


Related in: MedlinePlus