SEPARATION OF ISCHIOPAGUS TETRAPUS CONJOINED TWINS IN THE SULTANATE OF OMAN

Premature male ischiopagus tetrapus twins weighing 2.2 kg were born un expectedly. They required initial ventilation for respiratory distress syndrome and an emergency laparotomy for intestinal obstruction at 10 days of age. At 8 months of age, formal separation was carried out. P rimary skin closure was possible without the use of any tissue expande r. Anaesthesia was supplemented with continuous intra- and post-operat ive epidural analgesia, with great benefit. Both twins are alive and w ell 18 months after surgery; Details of the anatomical findings and pr eparation for surgery are discussed.