AbouZeid Amr A, Mohammad Shaimaa A, Radwan Ahmed B, ElDieb Leila, El-Gendy Yasmin G, Ibrahim Hanan, Amer Akram, Shabana Tarek, Elzahaby Hany, Elbarbary Amir, Saleh Mohamed, Abdelaziz Tarek H, Elbeshry Shady, Abdel-Hay Sameh, El-Ghoneimi Alaa, Zaki Ahmad
Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt.
Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt.
European J Pediatr Surg Rep. 2022 Mar 10;10(1):e53-e62. doi: 10.1055/s-0042-1743579. eCollection 2022 Jan.
Conjoined twining is one of the most fascinating and challenging situations which a pediatric surgeon may face in his career. Only few surgeons may have the opportunity to share in separation of such cases. In this report, we aim to share our experience with the successful separation of ventrally fused male conjoined twins (omphaloischiopagus). The case was thoroughly studied via preoperative cross-sectional imaging modalities (magnetic resonance imaging [MRI] and computed tomography [CT] angiography), complemented by data obtained from reviewing similar cases in the literature. A clear delineation of the complex anatomy was achieved preoperatively which proved to be well consistent with the operative findings. A detailed description of the operative procedure to divide/redistribute the shared abdominal/pelvic organs between both twins is provided. To the best of our knowledge, this is the first report to describe the detailed and unique internal anatomy of a common central phallus associating ischiopagus conjoined twins. The penis was centrally located in the perineum in between both twins with an open urethral plate. This common phallus had a peculiar configuration with four crura anchoring ischial bones of both twins together.
联体双胎是小儿外科医生在其职业生涯中可能面临的最引人入胜且最具挑战性的情况之一。只有少数外科医生可能有机会参与此类病例的分离手术。在本报告中，我们旨在分享成功分离腹侧融合的男性联体双胎（坐骨脐联体）的经验。通过术前横断面成像检查方法（磁共振成像[MRI]和计算机断层扫描[CT]血管造影）对该病例进行了全面研究，并参考了文献中类似病例的数据作为补充。术前实现了对复杂解剖结构的清晰描绘，结果证明与手术所见高度一致。本文详细描述了在两个双胎之间划分/重新分配共享的腹部/盆腔器官的手术过程。据我们所知，这是第一份描述坐骨联体双胎共同中央阴茎详细且独特内部解剖结构的报告。阴茎位于两个双胎之间的会阴中央，尿道板开放。这个共同的阴茎具有独特的结构，有四条阴茎脚将两个双胎的坐骨连接在一起。
