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Prosopo-Thoracopagus Conjoined Twins and Other Cephalopagus-Thoracopagus Intermediates: Case Report and Review of the Literature
Authors:Rowena Spencer  William H. Robichaux
Affiliation:(1) Former Associate Professor of Surgery, Louisiana State University School of Medicine and Clinical Associate Professor of Surgery, Tulane University School of Medicine, New Orleans, LA , US;(2) Department of Pathology and Laboratory Medicine, Tulane University Medical Center, New Orleans, LA 70112 , US
Abstract:
Prosopo-thoracopagus twins are united from the face down to the umbilicus, none with union in the brain but all with visceral anomalies intermediate between those of cephalopagus and thoracopagus. In a review of over 1200 cases of conjoined twins reported during the past 100 years, there were 14 that illustrate the continuum between cephalopagus and thoracopagus, including three that were united only from the cervical region to the umbilicus. Classic cephalopagus twins are joined from the top of the head to the umbilicus, sharing a single foregut as well as two relatively normal hearts, the “posterior” one often diminished. Typical thoracopagus, however, are conjoined only from the upper thorax to the umbilicus, each twin with a normal foregut but both sharing a single complex multiventricular heart. The intermediate cases shared either a single very abnormal heart or two hearts united by double aortic arches, and all except one had a single foregut. It is these cases intermediate between cephalopagus and thoracopagus which are the subject of this report. Received September 11, 1996; accepted December 16, 1996
Keywords:: conjoined twins, cephalopagus-thoracopagus intermediates, conjoined hearts {TX}“  Exceptions prove the rule, and the anomalies of Nature do good service by throwing much light upon her normal operations. The study of one group illustrates the other .   .   . double monsters do not result from a violation of those laws which govern our development, but simply from an embarrassment to their free operation”  [1].
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