Anesthesia for Pygopagus Conjoined Twins During Single-Twin and Simultaneous Pneumoperitoneum: A Case Report.

Abstract

We present the case of the first stage of separation of 9-month-old pygopagus conjoined twins who demonstrated minimal shared vasculature on preoperative imaging and no cross-sedation or cross-neuromuscular blockade during separate inductions of anesthesia. Laparoscopy was implemented in 1 twin at a time, then in both twins simultaneously. Despite insufflation of a single-twin's abdomen, both twins demonstrated hypercapnia and signs of a concomitant respiratory acidosis because of carbon dioxide diffusion through a shared peritoneal membrane. This is the first documented case of simultaneous laparoscopy-induced pneumoperitoneum in pygopagus conjoined twins.

• Authors: John-Paul Sara, Ashley Kydes, Olena Pryjdun, Michael Jacoby, Whitney McBride, Samir Pandya, Samuel Barst
• Journal: A&A practice (A A Pract) Vol. 11 Issue 3 Pg. 71-72 (Aug 01 2018) ISSN: 2575-3126 [Electronic] United States
• PMID: 29634556 (Publication Type: Case Reports, Journal Article, Twin Study)

Topics

• Abdomen
• Acidosis, Respiratory (etiology)
• Anesthesia, General (methods)
• Humans
• Hypercapnia (etiology)
• Injections, Intraperitoneal
• Insufflation
• Laparoscopy (methods)
• Pneumoperitoneum (diagnostic imaging, etiology)
• Twins, Conjoined (surgery)