Ali Endris Hussen, Abebe Yared Nigusie, Haile Milena Gebreegziabher, Bayable Abera
Unit of Neurosurgery, Ethiopian Police Hospital, Addis Ababa, Ethiopia.
Department of Neurosurgery, St. Paul's Millennium Medical College Hospital, Addis Ababa, Ethiopia.
J Neurosurg Case Lessons. 2025 Apr 28;9(17). doi: 10.3171/CASE24818.
Conjoined twins are a rare type of congenital malformation. The point of attachment is the primary factor used to classify conjoined twins; typically, this is front to front, with thoracopagus and omphalopagus twins accounting for about 75% of cases and pygopagus twins only between 6% and 19%.
This is a case report of 46-day-old female triplets born to a 37-year-old para 4 mother. Triplets A and B were conjoined at the lumbosacrococcygeal area dorsally. Triplet C was not conjoined. The conjoined triplets had a low birth weight; hence, it was decided to start nutritional management and achieve adequate weight gain before surgical separation. While on nutritional management, at 46 days of age, triplet B developed cardiorespiratory failure. Therefore, the multidisciplinary team decided to proceed with emergency neurosurgical separation surgery, with the primary aim of saving triplet A. Triplet B died 7 hours after the surgery due to irreversible cardiorespiratory failure, and triplet A remained in the hospital for 14 days and was discharged with intact neurological function.
Most cases of conjoined twins do not require emergency separation surgery and need nutritional support before the separation procedure. Separation surgery requires a multidisciplinary team meeting, planning ahead of time, and preparation. https://thejns.org/doi/10.3171/CASE24818.
联体双胎是一种罕见的先天性畸形。连接点是用于对联体双胎进行分类的主要因素；通常情况下，是面对面连接，胸腹联体双胎和脐联体双胎约占病例的75%，而骶部联体双胎仅占6%至19%。
本文报告一例37岁经产妇产下46日龄女性三胞胎的病例。三胞胎A和B在腰骶尾区域背部相连。三胞胎C未联体。联体三胞胎出生体重低；因此，决定在手术分离前开始营养管理并实现足够的体重增加。在营养管理期间，46日龄时，三胞胎B出现心肺功能衰竭。因此，多学科团队决定进行急诊神经外科分离手术，主要目的是挽救三胞胎A。三胞胎B在手术后7小时因不可逆的心肺功能衰竭死亡，三胞胎A在医院住院14天，出院时神经功能完好。
大多数联体双胎病例不需要急诊分离手术，在分离手术前需要营养支持。分离手术需要多学科团队会诊、提前规划和准备。https://thejns.org/doi/10.3171/CASE24818 。
