SUCCESSFUL SEPARATION OF THORACO-OMPHALOPAGUS AND ISCHIOPAGUS TETRAPUS TWINS IN KOREA

A pair of male thoracoomphalopagus twins with common liver, diaphragm, pericardium, and sternum was separated at the age of 59 days after a parasitic relationship had developed between them. Before separation o ne baby developed acute renal failure during which he had no edema and had normal serum electrolytes, urea nitrogen, and creatinine due to ' 'autodialysis'' by the other baby. The boys have now grown normally to the age of 6 years. A pair of female ischiopagus tetrapus twins who h ad a common terminal ileum and colon with imperforate anus was separat ed at the age of 20 h. The smaller baby had congenital multiple arthro gryposis of both lower extremities, a fracture at the middle of the le ft femur, and a double vagina with hydrocolpos due to an imperforate h ymen of the right vagina and a rectovaginal fistula on the left. Poste rior sagittal rectoplasties were performed at 7 months of age in both babies. They have normal bowel movements. All four children are alive and developing normally. These are the first two case reports of succe ssfully separated conjoined twins in Korea.