Surgical management of pygopagus parasiticus in a developing country: Challenges and review of the literature
Journal of Pediatric Surgery Case Reports
Conjoint twins are a rare aberration of monozygotic twinning which could be symmetric or asymmetric. Pygopagus parasiticus is a form of asymmetric twinning in which the parasitic or incomplete twin is attached to the autosite (dominant twin). We present our recent experience in the management of a case of pygopagus parasiticus highlighting the challenges peculiar to developing economies such as ours and how such challenges could be surmounted. Ó 2015 The Authors. Published by Elsevier Inc. This
... Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). Conjoined twins are a rare aberration of monozygotic twinning which has fascinated humanity and challenged the medical community for centuries. While symmetric conjoined twins comprise a set of equally developed twins with varying degrees of anatomic union, asymmetrical conjoined twins are characterized by a severely defective or incomplete twin (parasite) attached to and dependent on its largely intact co-twin (autosite). Asymmetric twins are also referred to as heteropagus or parasitic twins. The point of attachment or conjunction is the basis for the classification of the different anatomic types of conjoined twins . A major challenge to the management of this anomaly lies in its relative rarity and thus low individual surgeon exposure. In fact, a lot of the published work to date is based on isolated case reports  . Many recent reports from developed countries do not take into account peculiar challenges in the low and middle income countries (LMICs). Our recent experience in the successful management of this case aims to highlight such challenges and how they can be surmounted as well as review existing literature on the subject.