Anaesthetic challenges in conjoined twins' separation surger
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Conjoined twins are a rare congenital anomaly of unknown aetiology. We report the successful anaesthetic management of separation of ischiopagus tetrapus conjoined twins. The importance of a multidisciplinary approach, thorough pre-operative evaluation and planning, vigilant monitoring and anticipation of complications such as massive blood and fluid loss, haemodynamic instability, hypothermia and intensive, post-operative care are emphasised.Pre-operative evaluation revealed that baby A had normal facial features whereas baby B had dysmorphic facies, cleft lip and palate and a large cystic hygroma. Imaging studies revealed that they had a shared pelvis and a communicating spinal canal with a small meningocele. While baby A had a normal cardiopulmonary system, baby B had non-aerated lungs with visible tracheal shadow in chest X-ray and a univentricular heart with multiple other cardiac anomalies.In view of the above findings, baby B was diagnosed to be non-salvageable and considered to be a parasite, and hence, an early separation was planned. Both babies also had anorectal and urogenital malformation, and a colostomy was performed for baby A on the second post-natal day under local anaesthesia. The babies were nursed in the Neonatal Intensive Care Unit (ICU)...

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Dr. A●●●●●a J●●●i and 4 others like this
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H●●●a K●●●m
H●●●a K●●●m General Medicine
Wat about urogenital organs?
Jun 23, 2017Like