Successful Separation Of Conjoined Pygopagus Twins In African Environment With Limited Resources

Conjoined twins are identical or monozygotic twins whose bodies are joined in utero. Pygopagus or Iliopagus twins are a type of conjoined twins in which two bodies joined back to back at the buttocks. Surgical separation of conjoined twins is extremely risk of death and life threatening. We report on cases of female pygopagus twins of three months operated and separated at Kigali University Teaching Hospital. For both babies a posterior sagittal anorectoplasty was successfully performed with derivated ileostomy. Despite limited resources to carry out such operation in our settings, no complications occurred during the operation and oral feeding was done at third postoperative day. Ileostomy closure was performed three weeks after and babies were discharged from neonatology unit at 35th postoperative day. In conclusion, adequate preoperative investigation with a well organized and trained team contribute a lot to the success of such conjoined twins separation.Les jumeaux siamois sont des jumeaux identiques ou monozygotiques dont les corps sont joints ensemble in utero. Les jumeaux siamois appelés Pygopagus ou Iliopagus sont des jumeaux habituellement joints au niveau du dos. La séparation chirurgicale de ce type de jumeaux siamois est extrêmement délicate et comporte souvent un risque de décès ou de complications pouvant mettre en jeu le prognostic vital. Ici nous rapportons deux cas de jumelles siamoises Pygopagus âgées de 3 mois qui ont été séparées chirurgicalement à l’Hôpital Universitaire de Kigali. Chez les deux siamoises, une opération consistant en anorectoplastie saggitale postérieure avec iléostomie dérivée a été pratiquée avec succès. Malgré les les moyens techniques limités pour mener une telle opération dans nos facilités, aucune complication n’a été observée durant l’opération et l’alimentation par voie orale a été retablie après trois jours portopératoires. La fermeture d’iléostomie a eu lieu trois semaines après et les deux jumelles sont sorties de l’Hôpital après 35 jours postopératoires. En conclusion, les investigations préopératoires adéquates avec une équipée bien formée et organisée contribuent énormément à la réussite d’une telle opération

Successful surgical separation of conjoined twins: First experience in Rwanda

Conjoined twins are identical or monozygotic twins whose bodies are joined in utero. Pygopagus or Iliopagus twins are a type of conjoined twins in which two bodies joined back to back at the buttocks. Surgical Separation of conjoined twins is extremely risk of death and life threatening. Female pygopagus twins of three months were been operated and separated at Kigali Teaching University Hospital. For both babies a posterior sagittal anorectoplasty was performed with derivated ileostomy without problem. No complications occurred during the operation, oral feedings was done at third postoperative day. Ileostomy closure was done three weeks after and babies were discharged from neonatology unit at 35th postoperative day. Adequate preoperative investigation with a well organized and trained team contributed a lot to the success of conjoined twins separation