SynthesisPediatric surgery international2022
Heteropagus twins: six cases with systematic review and embryological insights.
Synthesis in Pediatric surgery international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Epigastric Heteropagus Twin in a Term Neonate: Early Diagnosis, Multidisciplinary Separation, and Favorable Outcome: A Case Report.European journal of pediatric surgery reports · 2026Article
- Evaluation of the Ethical Controversies in Separation Surgery of Conjoined Twins: A Review of the Literature.Cureus · 2025Review
- Phenotypically Discordant Anomalies in Conjoined Twins: Quirks of Nature Governed by Molecular Pathways?Diagnostics (Basel, Switzerland) · 2023Review
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5 authors.
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Abstract
purposeHeteropagus twinning (HT) is a rare anomaly. Six new cases along with a systematic review are described.
methodsSix cases of HT managed at two tertiary care teaching hospitals over the last 26 years are described. A PubMed search with words: Heteropagus AND/ OR parasitic twins from 2001 to 2021 hit 183 articles. 36 were added from non-PubMed sources. Finally, 120 cases including 114 from 69 articles and 6 new cases were analysed.
resultsOf the new cases, 2/6 had an antenatal diagnosis. Five were males. 4 autosites had omphaloceles. Split notochord and 2 parasites attached to a single autosite were encountered. 5/6 autosites survived. On systematic review, the most frequent variant seen was rachipagus (n = 50) followed by omphalopagus (n = 46). Limbs were reported in 75 cases. Congenital heart disease was seen in 17/120(14.2%) autosites. Omphalocele and meningomyelocele were the most common extracardiac anomalies in autosites. Weight along with the anatomy and position of heteropagus twins was a better determinant of the mode of delivery than weight alone. Mortality was reported in 12 cases.
conclusionAutosites in HT generally carry a good prognosis, however, final outcome depends mainly on associated major cardiac anomalies. Meticulous antenatal assessment and preoperative planning are of paramount importance. LEVEL OF EVIDENCE: IV.
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