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Original ArticleOpen Access
Conjoined Twins : Surgical Separation in 11 Cases
Watanatittan S 
,
Niramis R ,
Suwatanaviroj A ,
Havanonda S
,
Niramis R ,
Suwatanaviroj A ,
Havanonda S RANGSAN NIRAMIS, MD*,
SRIWONGSE HA V ANONDA, MD*
Eleven pairs of symmetrically conjoined twins underwent surgical separation at the Queen
Sirikit National Institute of Child Health. Six were omphalopagus, 4 were thoracopagus and 1 was
pygopagus. Eight were female and 3 were male. Three pairs were separated on emergency or semi-
emergency bases, and the remaining 8 pairs were separated electively at an older age.
Of the 3 pairs who had early emergency separations, one pair, whose combined birth weight
was only 2,500 g, underwent emergency separation at the age of 44 days after the death of one twin.
The second twin also expired one hour after the separation. In the remaining 2 pairs, early separation
was done because of the deterioration of one twin due to complex cardiac anomalies. In both cases,
the infants with cardiac anomalies expired but the others survived the separation satisfactorily.
In one pair of thoracopagus conjoined twins, one twin had cyanotic cardiac anomalies. They
were electively separated at the age of 2 years and 9 months. The twin with cardiac anomalies expired
2 hours after surgery, but the other survived the separation satisfactori I y.
In the remaining 7 pairs who underwent elective separations, both twins of each pair survived
the separation satisfactorily. However, one twin expired unexpectedly 10 days after the separation.
Key word : Conjoined Twins, Siamese Twins, Thoracopagus, Omphalopagus, Pygopagus, Separation
SRIWONGSE HA V ANONDA, MD*
Eleven pairs of symmetrically conjoined twins underwent surgical separation at the Queen
Sirikit National Institute of Child Health. Six were omphalopagus, 4 were thoracopagus and 1 was
pygopagus. Eight were female and 3 were male. Three pairs were separated on emergency or semi-
emergency bases, and the remaining 8 pairs were separated electively at an older age.
Of the 3 pairs who had early emergency separations, one pair, whose combined birth weight
was only 2,500 g, underwent emergency separation at the age of 44 days after the death of one twin.
The second twin also expired one hour after the separation. In the remaining 2 pairs, early separation
was done because of the deterioration of one twin due to complex cardiac anomalies. In both cases,
the infants with cardiac anomalies expired but the others survived the separation satisfactorily.
In one pair of thoracopagus conjoined twins, one twin had cyanotic cardiac anomalies. They
were electively separated at the age of 2 years and 9 months. The twin with cardiac anomalies expired
2 hours after surgery, but the other survived the separation satisfactori I y.
In the remaining 7 pairs who underwent elective separations, both twins of each pair survived
the separation satisfactorily. However, one twin expired unexpectedly 10 days after the separation.
Key word : Conjoined Twins, Siamese Twins, Thoracopagus, Omphalopagus, Pygopagus, Separation
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