Clinical and Medical Case Reports

Biography

Biography: Zehara Hamdihun Essa

Abstract

Background: - Conjoined twins are one of the rare developmental anomalies, where twins do not separate completely. They are of two types, symmetrical the common type and asymmetrical the rarest. Asymmetrical twins are of two types, one is parasitic twin (heteropagus) and the other is fetus in fetus. The incidence of heteropagus (parasitic) twin’s is less than 1 per 1 million births.We report Pygopagus parasiticus twin of unique presentation. Case presentation: - Parasitic conjoined twin born from 28 years old primigravida lady through spontaneous vaginal delivery at gestational age of 35 weeks and 4 days after she was admitted with the diagnosis of preterm premature rupture of membrane to Felege Hiwot referral hospital in Bahir Dar, Ethiopia. Upon examination, the parasite twin (enlarged embryo) of 58mm CRL and 30gm weight attached to the viable autosite through 110 mm long and 6 mm diameter tail like structure extending from caudal part of the embryo (parasite) to the skin overlying the sacral area 10mm left lateral from the midline. The parasite (enlarged embryo) has embryonic structures at about 5 weeks. Ultrasound and x-ray was done to the autosite and there was no associated gross congenital anomaly. After parents’ request for cultural and cosmetic reasons, the parasitic twin was separated by minor surgical excision. The autosite discharged well and it was in good health at postpartum visits. Conclusion: - An extremely rare co-incidence of parasitic twining as human true tail is reported and it may give evidence in the controversial pathogenesis of conjoined twin. It also helps us to widen our views on pathogenesis of human true tails. Some of case reports on human tail can be ruminants of the twin process that has arrested at early embryonic age or lost its distal component by ischemic resorption rather than the true human tail.