2021 Volume 57 Issue 3 Pages 663-667
Epigastric heteropagus twins are asymmetric conjoined twins in which the parasite is attached to the epigastrium of the autosite. In epigastric heteropagus twins, the intestine originating from the parasite might exist in the omphalocele of the autosite or join to the intestine of the autosite, which could increase the risk of surgical complications. Here, we report the case of full-term epigastric heteropagus twins in which the autosite had an omphalocele and the parasite had a well-developed left lower limb and pelvis. Contrast-enhanced computed tomography revealed a vascular supply from the inferior phrenic artery of the autosite to a cyst within the omphalocele as well as the parasite. On the 5th day of life, primary closure of the omphalocele was successfully performed after an independent loop of the intestine with both ends blind within the sac of the omphalocele was excised. On the 21st day of life, the parasite including its developed phallus and scrotum, an abdominal testis, a single kidney with ureter, and a bladder filled with urine was separated. On the 32nd day of life, the patient was discharged following an unremarkable postoperative course. A comprehensive review of this rare entity including data from English and Japanese literature is presented.
