A case report of Conjoined Twin(PYGOPAGUS) separation
Journal Title: Journal Of Pediatric Critical Care - Year 2014, Vol 1, Issue 1
Abstract
We report successful separation of PYGOPAGUS twins. Meticulous planning and multidisciplinary approach are the core aspects in the management of Pygopagus conjoined twins. Early elective separation versus delayed separation of the conjoined twins improves the survival from 40% to 80% . Preoperative assessment of sickle cell disease, cross-circulation and organ sharing between twins proved valuable for planning sedation and analgesia and allowing detailed scripting of the complex anesthetic induction sequence, airway management, complex neurological monitoring and post operative intensive care related issues. Fusion of lower back, spinal cord , nerve roots , and rectal and genitourinary tract was a major surgical challenge related to potentially adverse neurological outcomes, bladder /bowel dysfunction and intact long term survival. Post operative critical care issues such as pain , prone ventilation, sickle cell sequalae, cerebrospinal fluid leak and meningitis, wound infection and colostomy care, nutrition, and other potential complications are discussed in detail in this report. We emphasize the role of pediatric intensive care, preoperative planning with multidisciplinary team, and staged surgical intervention and a good postoperative care in the successful management of complicated variants.
Authors and Affiliations
Dr. Praveen Khilnani, Dr Rachna Sharma, Dr Zahid Hussain, Dr Prashant Jain, Dr Bhaskar Saikia, Dr Pradeep Sharma
Keywords
Related Articles
- EP ID EP336871
- DOI 10.21304/2014.0101.00010
- Views 89
- Downloads 0
Inhalational Volatile Anesthetic In Super Refractory Status Epilepticus - A Case Series From A Tertiary Care Center
.
Pre Hospital Pediatric Trauma: EMS experience, Improving the Prehospital Care and Road Map for the Future
Objectives: study the Pediatric (age 0-14 years) prehospital trauma pattern for year 2015 in Telangana (TS) and Andhra Pradesh (AP). To highlight the experiences of pre hospital training and injury prevention measures in...
Common Congenital Heart Defects and Perioperative Issues in Management
.
Ultrasound appearance of lungs in patients with ventilator associated pneumonia
To document ultrasound appearance of lungs in mechanically ventilated patients with (ventilator associated pneumonia) VAP.
Transorbital Ultrasound of Optic Nerve Sheath Diameter in children with Raised Intracranial Pressure
.