Rosenberg H K, Spackman T J, Chait A
AJR Am J Roentgenol. 1978 May;130(5):921-6. doi: 10.2214/ajr.130.5.921.
Alta and Clara, the Dominican Republic conjoined twins (ischiopagus, omphalopagus, tetrapus) were evaluated prior to separation with plain films, vaginograms, arteriograms, intravenous pyelogram, barium enema, and upper gastrointestinal series with small bowel follow-through. The clear demonstration of their internal anatomy allowed the surgeons to plan the operative approach and to make a reasonable judgment regarding viability of each baby. Each twin had a semicircular pelvis which joined the other to form a complete ring. There were a few hepatic arterial twigs from Alta which crossed the midline, proving at surgery to be a small bridge of tissue connecting the two livers. Clara's superior mesenteric arteries supplied the majority of the small bowel. Portal venous drainage was separate for each twin. Each baby had two kidneys in normal position with the bladders laterally placed. Each bladder received one ureter from each twin. Two separate small bowels joined proximal to the single colon which terminated in an anus related to Clara's pelvic structures. Following separation, each baby did well. Their postoperative anatomy is described.
阿尔塔和克拉拉是多米尼加共和国的联体双胞胎（坐骨联体、脐联体、四肢联体），在分离手术前，通过X线平片、阴道造影、动脉造影、静脉肾盂造影、钡剂灌肠以及上消化道造影加小肠造影对她们进行了评估。清晰显示的内部解剖结构使外科医生能够规划手术方案，并对每个婴儿的生存能力做出合理判断。每个双胞胎都有一个半圆形骨盆，与另一个相连形成一个完整的环。阿尔塔有几根肝动脉小分支穿过中线，手术证实这是连接两个肝脏的一小片组织桥。克拉拉的肠系膜上动脉供应大部分小肠。门静脉引流对每个双胞胎都是分开的。每个婴儿都有两个位置正常的肾脏，膀胱位于两侧。每个膀胱从每个双胞胎接收一条输尿管。两条独立的小肠在单一结肠近端相连，结肠末端通向与克拉拉骨盆结构相关的肛门。分离手术后，每个婴儿情况良好。描述了她们术后的解剖结构。
