The separation of pygopagus conjoined twins with fused spinal cords and imperforate anus

Authors

Barrett P. Cromeens, Nationwide Children’s Hospital
Jeffrey R. Leonard, Nationwide Children’s Hospital
Lance S. Governale, Nationwide Children’s Hospital
Richard E. Kirschner, Nationwide Children’s Hospital
Gregory D. Pearson, Nationwide Children’s Hospital
Marc A. Levitt, Nationwide Children’s Hospital
Richard J. Wood, Nationwide Children’s Hospital
Rajan K. Thakkar, Nationwide Children’s Hospital
Monica P. Islam, Nationwide Children’s Hospital
Jennifer L. Mckinney, Nationwide Children’s Hospital
Emmett E. Whitaker, Nationwide Children’s Hospital
Jason A. Bryant, Nationwide Children’s Hospital
Brent H. Adler, Nationwide Children’s Hospital
William C. Ray, Nationwide Children’s Hospital
Brad Hoehne, Nationwide Children’s Hospital
Gail E. Besner, Nationwide Children’s Hospital

Document Type

Journal Article

Publication Date

8-1-2016

Journal

Journal of Pediatric Surgery Case Reports

Volume

11

DOI

10.1016/j.epsc.2016.06.005

Keywords

3D printing; Conjoined twins; Pygopagus

Abstract

© 2016 The Authors Each set of conjoined twins has specific anatomic features dictating unique challenges to separation. Overcoming these challenges requires creative solutions that necessitate interdisciplinary collaboration. We present a unique case of pygopagus conjoined twins with fused spinal cords, imperforate anus without fistula, and a single anal sphincter complex. Separation included the use of novel applications of 3D printing and neurophysiologic monitoring. The 3D print helped to clarify the complex anatomy and facilitate communication during planning sessions. The neurophysiologic monitoring helped to distinguish a plane of separation for the spinal cords as well as the shared anal sphincter. Implementing these technologies and thus successfully separating these twins safely required a multidisciplinary team that extended beyond clinical specialties.

APA Citation

Cromeens, B., Leonard, J., Governale, L., Kirschner, R., Pearson, G., Levitt, M., Wood, R., Thakkar, R., Islam, M., Mckinney, J., Whitaker, E., Bryant, J., Adler, B., Ray, W., Hoehne, B., & Besner, G. (2016). The separation of pygopagus conjoined twins with fused spinal cords and imperforate anus. Journal of Pediatric Surgery Case Reports, 11 (). http://dx.doi.org/10.1016/j.epsc.2016.06.005