Thoracopagus parasiticus

Thoracopagus parasiticus

Case (1)

Observation

Parasitic twins

Assymetrical,unequal conjoined twin

Cause : -- Parasitic twins occur when a twin embryo begins developing in utero, but the pair does not fully separate, and one embryo maintains dominant development at the expense of the other.

-- The undeveloped twin is defined as parasitic, . The independent twin is called the autosite.

-Both are assymetrical

- The Fetuses share : 1 heart , 1 intestine , 1 stomach , 1 spleen , 2 lungs ,1 liver>> so the abnormal fetus just depends on the healthy one >> "PARASITICUS"

Conjoined at thorax >>> Thoracopagus

Conjoined twins

Thoracopagus

--The incidence of conjoined twins is estimated at 1 in 50 000 births.

-- Thoracopagus is the most common form

of conjoined twins with fusion from the anterior thorax to the umbilicus.

-- Conjoined hearts are seen in 75%.

--Of ventral type.

--It occurs 19% of all cases

Case (1)

Thoracopagus parasiticus

Conclusion

Second Fetus

First Fetus

Case 1 >>> Thoracopagus Parasiticus.

Characters :

- cephalic perimeter : 270mm

- feet length : 60mm

- Thoracic perimeter : 230mm

- Cephalic perimeter : 330mm

- Crown-rump length : 280mm

- Crown-heel length : 480mm

- Feet length : 70mm

There's only one rare exceptional case reported all over the world >>>

"Lazarus and Joannes Colloredo "

The Internal Organs

N.B :

- there are 2 kidneys.

-Only one testicle in abdomen.

-Trachea

-Lungs

-Heart

-Esophagus

-Stomach

-Intestine

-Kidney

-Spleen

-Testicles

General Product

Internal Organs

The upper Limb

Sex : Male.

Age : 28 -32 weeks (By somatometry) .

Abnormal Fetus with multiple anomalies :

-Cleft Hand.

-Unilateral complete cleft lip & palate.

- 2 arms ( with short humerus , and no radius) - 1 leg.

- Lumbar vertebrae show "Spina bifida".

-Undescended testis , with only one testicle in abdomen.

- no internal organs except Kidneys.

N.B :

- There are 2 testicles , but they are descended in scrotum.

-Trachea

-Lungs

-Heart

-esophagus

-Stomach

-Intestine

-Kidney

-spleen

-Testicles

The Ear

The Trunk

Structure : -2 arms.

-2 short humerus

-2 normal ulna

-no radius

Abnormality : Cleft Hand (Central Deficiency)

Development of nails & Fingers : 40% ( 2 fingers with 3 phalanges each).

General structure : Normal

Auditory meatus : permeable

Position : normal and vertical

Lower Limb

Structure : 2 legs

Developpment of nails and toes : 100%

Neck : normal ( 7 cervical V.)

Thorax : normal ( 12 thoracic V.)

Abdomen : abnormal ( 5 lumbar V. with spina bifida)

Pelvis : nomral ( sacral V. & coccygeal V.)

The General product

Sex : Male

Age : 28 - 32 weeks ( By somatometry)

Normal Healthy one with Scoliosis

-Skin :Normal.

-Form of skull :Normal.

-Eyes :Normal,with no fusion.

Umbilical Cord

Skin : Normal

Form of skull : Normal

Eyes : normal without fusion

Structure : -Only one for both fetuses

-2 umbilical arteries and one umbilical Vein

External Genitalia

Upper limb

The Nose & Mouth

Structure : 2 arms

Developpment of fingers & nails : 100%

N.B : the nail is mixed with meconium (that was in the amniotic fluid)

Sex : Male

Anomaly : Undescended testis , 1 testicle in abdomen.

External Features : - Normal penis,with urethral opening

-scrotum with no testicles

Nose : Normal

Mouth : Abnormal

Tongue : Normal

Lineo trago-oral : normal (no fistula , no appendix)

Lips & Palate : Complete unilateral cleft

Anus

The Lower Limb

External Genitalia

The Ear

Meconium during fetal life

Anus : open with meconium

What's meconium ?

just the baby first feces,dark green, developped during early pregnancy and just before birth

Structure : Abnormal , one leg

Development of toes and nails : 80%

Cause : -mainly realted to fetal stress ,due to infection,

>>> increase intestinal activity >> relaxation of anal sphincter>>passage of meconium to amniotic fluid

Sex : Male

Features : - penis

-scrotum with two descended testicles

Danger : it can be inhaled, blocking some airways

The Nose & Mouth

The trunk

General structure : Normal

Auditory meatus : permeable

Position : Normal & Vertical

Nose : Normal

Mouth : Normal

Tongue : Normal

Lineo trago-oral : Normal (No fistula,no appendix)

Palate &Lips : Normal

Anus : Absent

Umbilical Cord : Absent

Neck : normal ( 7 cervical V. )

Thorax : Normal (12 thoracic V.)

Abdomen : normal (5 lumbar V.)

Pelvis : normal ( sacral V. & coccyegeal V.)

Anomaly : Scoliosis.

Lazarus & Joannes colloredo (in 1640s)

Joannes Colloredo was possibely the first surviving parasitic twin, who has a head.

Lazarus was, developed normally until his ingrown parasitic brother. Joannes Baptista was fused with Lazarus; he had two arms and a leg. His head was the appropriate age hair and beard, the eyes were usually closed.