이종결합체

Abstract

Heteropagus is unequal and asymmetrical conjoined twins, one component of which is smaller than and dependent on the other. It consists of two members of very unequal degrees of development, the one (autosite) being normal or nearly so and the other (parasite) being incomplete. It is attached to the first as a dependent growth, usually attached to some point on the ventral surface. This twins were delivered to a 30 year old mother after 23 weeks of gestation. The twins were joined on anterolateral chest. The one (autosite) was grossly normal, while the other (parasite) was smaller. At the autopsy, the twins weighed 202gm, and were 22. Scm and 8. Scm in crown-heel lengths each. The autosite was grossly normal. The parasite had poorly developed cystic head portion, two arms and two legs. One umbilical cord was attached to the lower conjoined site. Between autosite and parasite, the internal organs had no connection. In autosite, the anomalies of the heart and great vessels were complete transposition of the great vessels, atrial septal defect, ventricular septal defect and incomplete development of tbe left ventricle. In parasite the head portion had no brain parenchyme and skull bone. There was vestigial epiglottis and larynx seen in this cavity. The heart anomalies consisted of common ventricle and atrial septal defect. The aortic branch draining head portion was poorly developed but the right lung was incompletely bilobed. In abdominal cavity, there were two spleens of almost same size. On serial sections of umbilical cord, there were one vein and four arteries. One vein and 1wo arteries drained into the autosite while the other two arteries iinto the parasite. This case is the second example of polysplenia 'seen in conjoined twins in is Department. And -combined anomalies seen in both parasite and autosite were of interest in terms of their pathogenesis and relationship to the heterotaxia.