33 / 330
33
19–22 APRIL, 2017, BARCELONA, SPAIN
S3: CASE REPORTS
Moderators: Pedro Lopez Pereira (Spain), Rita Gobet (Switzerland)
ESPU Meeting on Wednesday 19, April 2017, 15:35–16:45
15:35–15:37
S3-1 (CP)
THE FATE OF CONJOINED PARAPAGUS TWINS: 16 YEARS
AFTER SUCCESSFUL SEPARATION
Paloma TRIANA
1
, Mariela DORE
1
, Javier JIMENEZ
1
, Virginia AMESTY
2
,
Roberto LOBATO
2
, Susana RIVAS
2
, Pedro LOPEZ PEREIRA
2
and Maria Jose MARTINEZ URRUTIA
2
1) Children’s Hospital La Paz, Pediatric Surgery, Madrid, SPAIN - 2) Children’s Hospital La Paz, Pediatric Urology,
Madrid, SPAIN
PURPOSE
Birth of conjoined twins is unique and a successful separation is a challenge. Evolution of these
patients and long-term follow-up is hardly ever mentioned. We present the evolution of conjoined
parapagus twins, successfully separated in year 2000.
MATERIAL AND METHODS
Retrospective and prospective review of surgical and medical treatment of conjoined parapagus
twins and long-term follow-up.
RESULTS
Conjoined twins Fátima(F)and Amina(A)shared two lower limbs, lumbosacral spine, rectum, anus
and genitourinary system, offering an only perineum. They had left prevertebral kidney andAhad
an annular pancreas. Separation was performed by a multidisciplinary team at 16 months of age,
remaining both of them with terminal sigmoidostomy, ipsilateral kidney draining to the hemibladder
enlarged with hemirectum, hemivagina with correspondent ovary and tube, complete uterus inA,
two upper limbs and only lower limb. Coverage was fulfilled with previous expanded skin.
Both have neurogenic bladder due to separation of lumbosacral spine. Awas incontinent and main-
tained good renal function, while F needed anticholinergics and intermittent catheterization. Flead
into end-stage renal disease 13 years later after numerous episodes of acute pyelonephritis and
lithiasis, requiring haemodyalisis, urinary diversion Hendren type and renal transplantation, which
became complicated with acute cholecystitis and pancreatitis. Both walk with the help of a crutch
and attend school regularly.
CONCLUSIONS
Surgical separation of conjoined twins is always reason to be proud by the surgical team. Despite
initial success, we shall not forget that they are chronic patients who need individualized and multi-
disciplinar approach considering their anatomical variations.