Rahayatri TH, Amaliah R, Putri NM, Puspaningtyas NW, Karyanti MR, Hendarto A. Omphalopagus conjoined twins separation during coronavirus disease-19 pandemic era: A case report.
Int J Surg Case Rep 2021;
84:106150. [PMID:
34221850 PMCID:
PMC8240450 DOI:
10.1016/j.ijscr.2021.106150]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction and importance
Conjoined twin is a rare congenital anomaly characterized by a fusion of certain anatomical structures. Coronavirus-19 (COVID-19) is a new emerging infectious respiratory disease affecting worldwide and potentially leads to acute respiratory distress (ARDS) in children. COVID-19 has reconstructed the healthcare system, including surgical care and decision-making.
Case presentation
Herein we describe a surgical separation of 2.5 months old omphalopagus conjoined twins, with one of them (Baby A) presenting COVID-19-associated respiratory distress, as well as the challenges faced during the preparation and the execution of the complex surgical procedure.
Clinical discussion
Baby A underwent antiviral therapy, oxygen supplementation, and ventilation in the ICU, while baby B remained stable and confirmed negative for SARS-CoV-2. The separation surgery was conducted after baby A had become clinically stable. Defect closure and reconstruction were accomplished. At one week follow-up, Baby A died of lung infection, while baby B remained well after one year.
Conclusion
The complexity of surgical separation requires careful planning by a multidisciplinary team. Surgical separation of conjoined twins during the pandemic era has not been reported much in the literature, more reports are required to provide further insight.
Omphalopagus conjoined twins separation surgery is an intricate procedure that requires a multidisciplinary team
The separation surgery of conjoined twins during the COVID-19 pandemic necessitate a unique surgical preparation and disciplined health protocols.
The ideal timing of separation surgery of conjoined twins in the COVID-19 pandemic era remains controversial, factors that may play a role in the decision making include the age, weight, general clinical condition, and the complexity of fusion identified
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