Clinical Image - International Journal of Clinical & Medical Images (2014) Volume 1, Issue 3
Author(s): Int J Clin Med Imaging 2014
The following is a case of thoraco-omphalopagus conjoined twins on post-partum day 40 undergoing mesenteric angiography under general anesthesia in the interventional radiology suite. The purpose of the examination was to delineate the mesenteric vascular tree to assess the possibility of surgery to separate the twins. Since the twins shared a common liver, plans were made to perform this study to map the hepatic vasculature and assess whether the liver could be separated and have each portion adequately perfused and drained by each individual twin. Although the bulk of the liver was housed in the abdomen of Twin A, its vasculature supply (by prior CT exam) was mostly contributed from Twin B. Review of the angiographic study between the pediatric surgeons and radiologists suggested that separation surgery could be considered in the future, but serial studies will be required first to ascertain if the celiac, SMA, and portal systems of Twin A will continue to grow enough to support her own hepatic system.
Eric A. Harris
Department of Anaesthesiology
School of Medicine University of Miami