open access

Vol 46, No 2 (2014 Apr-Jun)
Review articles
Submitted: 2014-05-09
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Anaesthesia of conjoined twins

Krzysztof Kobylarz
DOI: 10.5603/AIT.2014.0023
·
Anaesthesiol Intensive Ther 2014;46(2):124-129.

open access

Vol 46, No 2 (2014 Apr-Jun)
Review articles
Submitted: 2014-05-09

Abstract

Conjoined twins have been a source of fascination to the public and the medical profession for centuries. Their birth was initially viewed as an ominous sign of impending disaster. Since Middle Ages into the 19th century they were regarded as monstrosities and were exhibited at circuses and sideshows. The frequency of conjoined twins is approximately 1 in 50,000 gestation, but many of them die in utero, are terminated or stillborn. The true incidence is estimated to be 1 in 200,000 live births. This article gives an overview of Siamese twins and of the prenatal diagnosis in assessing the prognosis, anaesthetic and post-natal surgical management and outcome. Anaesthesia for conjoined twins surgery, whether prior to or for separation, is an enormous challenge to the anaesthesiologist. The site and complexity of the conjunction affect management of the airway, an intravenous access, the extent of blood and number of surgical specialties involved. Preoperative assessment and planning with interdisciplinary communication and cooperation is vital to the success of the operations. Meticulous attention to detail, monitoring and vigilance are mandatory.

Abstract

Conjoined twins have been a source of fascination to the public and the medical profession for centuries. Their birth was initially viewed as an ominous sign of impending disaster. Since Middle Ages into the 19th century they were regarded as monstrosities and were exhibited at circuses and sideshows. The frequency of conjoined twins is approximately 1 in 50,000 gestation, but many of them die in utero, are terminated or stillborn. The true incidence is estimated to be 1 in 200,000 live births. This article gives an overview of Siamese twins and of the prenatal diagnosis in assessing the prognosis, anaesthetic and post-natal surgical management and outcome. Anaesthesia for conjoined twins surgery, whether prior to or for separation, is an enormous challenge to the anaesthesiologist. The site and complexity of the conjunction affect management of the airway, an intravenous access, the extent of blood and number of surgical specialties involved. Preoperative assessment and planning with interdisciplinary communication and cooperation is vital to the success of the operations. Meticulous attention to detail, monitoring and vigilance are mandatory.

Get Citation

Keywords

conjoined twins, anaesthesia; conjoined twins, diagnostics; conjoined twins, management

About this article
Title

Anaesthesia of conjoined twins

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 46, No 2 (2014 Apr-Jun)

Pages

124-129

DOI

10.5603/AIT.2014.0023

Bibliographic record

Anaesthesiol Intensive Ther 2014;46(2):124-129.

Keywords

conjoined twins
anaesthesia
conjoined twins
diagnostics
conjoined twins
management

Authors

Krzysztof Kobylarz

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