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  CRANIOPAGUS : FUSED AT THE HEADS
(Ram - Lakshman)
  CRANIOPAGUS : FUSED AT THE HEADS.
(Veena - Vani)
  Anjali- Geethanjali
(Xiphi-Omphalo Pagus)
  Rekha - Surekha
(Ischeo-pagus. Tetrapus)
 
CASE REPORT
REKHA - SUREKHA (Ischeo-pagus. Tetrapus)
Rekha - Surekha (Ischeo-pagus. Tetrapus) Rekha &Surekha were born on 2nd June, 1998. They were admitted on the same day within 6hrs of birth to children surgical ward at GMC General Hospital, Guntur. They were fused at the pelvis anteriorly and passed urine and me conium with the 1st 48 hours of birth. Significantly they had single anal orifice which was ectopic ( Vestibular anus). They were nursed in the hospital. They had a few infections (G.E., URI: skin infections), which responded with treatment.

They were studied with relevant investigations, Radiological workup- Plain X-rays, contrast studies (Barium meal, Ba. Enima) 1.V.P apart from ultrasound, CT scan, MRI scan They were operated on 23 October 2002.
At Operation it was found :
The upper Gastro Intestinal tract was separate up to the level of distal ileum (Meckle's diverticulum) and beyond that it was a single channel i.e. Distal ileum, colon & rectum.
Internal Genital Organs.
Uterus didelphys was found in both.
Ovaries and tubes were normal.
Fusion of bony pelvis (cartilaginous and soft tissue attachments).
Urinary System - utreters, urinary bladder and urethra were normal for both babies.
Reconstruction of gastro intestinal tract with anastomosis was done to the child with anal orifice.
Reconstruction of Gastro Intestinal Tract was established with end colostomy to the child with out anal office.
Separation of pelvis and reconstruction of External genitalia - Labia, Clitoris and vagina was done in both babies
Reconstruction of lower abdomen and pelvis completed the operation Operation lasted for 7.30 hrs and both children recovered well from anesthesia maintained stable vital signs.
Post operatively both the babies did well. They were rehabilitated to stand and walk without any support. At present they are 5 years old and are doing extremely well. They are in the preschool stage.
 
 
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