In a rare medical occurrence, conjoined twins were born in Indonesia with three legs, four arms, and a fused pelvis. These twins, referred to as "spider" twins due to their unusual limb arrangement, share one bladder, rectum, and intestine. This extraordinary case was reported in the American Journal of Case Reports, highlighting its rarity and complexity.
The twins, born in 2018, are classified as Ischiopagus Tripus, a condition where twins are joined at the pelvis. They have two functional legs and arms, one non-functional leg, and share one penis and anus. For the first three years of their lives, the twins were unable to sit up and had to lie flat due to their unique body structure.
After extensive consultations with the hospital ethics committee, institution review board, and the parents, surgeons decided to amputate the non-functional third leg and stabilize the twins' hip and pelvic bones. The surgery aimed to improve their quality of life by enabling them to sit upright. Remarkably, the twins experienced no complications post-surgery.
Conjoined twins occur in approximately one in 50,000 to 200,000 pregnancies, resulting from an incomplete split of the fertilized egg. This process, occurring around eight to twelve days after conception, results in two embryos developing while remaining physically connected. Ischiopagus twins, where the connection is at the pelvis, account for only six to eleven percent of conjoined twin cases.
The Indonesian twins' case is exceptionally rare, with such occurrences estimated to be one in two million. The parents, who have two older children and no family history of medical issues, reported no complications during pregnancy. The rarity and complexity of their condition have drawn significant attention in the medical community.
In similar historical cases, medical teams have faced substantial challenges. For instance, in 1992, doctors in China successfully separated conjoined twins who had two functional arms and legs, one non-functional leg, and shared genitalia. This surgery took over ten hours and was performed when the twins were two years old. Another case in Pakistan in 2011 involved conjoined twins with severe developmental issues, including small head and underdeveloped genitalia. Unfortunately, both children in this case did not survive.
The Indonesian twins have overcome significant odds. Despite being unable to sit up for the first three years, their post-surgery recovery has been successful, allowing them to sit upright. This case underscores the complexity and challenges associated with Ischiopagus Tripus and conjoined twins in general.
Only just a few of these cases are documented in medical literature, making each one an invaluable source of data for upcoming procedures and therapies. This case, which was just published in the American Journal of Case Reports, provides insightful information about the care and surgical procedures for conjoined twins.
(Input from various media sources)
(Rehash/ Susmita Bhandary/MSM)
