Ischiopagi

A type of conjoined twins joined at the pelvis

Ischiopagi are a rare form of conjoined twins where the twins are joined at the pelvis. This condition is characterized by the fusion of the lower half of the body, which can include the pelvic bones, sacrum, and sometimes the lower spine. The term "ischiopagus" is derived from the Greek words "ischion" meaning "hip" and "pagos" meaning "fixed" or "fastened".

Classification

Ischiopagi are classified based on the extent and nature of the fusion. The most common types include:

• Ischiopagus tripus: In this form, the twins share a single pelvis and have three lower limbs. Two of the limbs are usually functional, while the third may be rudimentary or non-functional.
• Ischiopagus tetrapus: Also known as "quadripus," this type involves four lower limbs, with each twin having two legs.

Anatomical Features

Conjoined ischiopagus tripus twins

In ischiopagus twins, the fusion typically involves the lower gastrointestinal tract, genitourinary system, and sometimes the spinal cord. The degree of organ sharing can vary significantly, affecting the complexity of surgical separation.

Skeletal System

The skeletal system in ischiopagus twins is characterized by a shared pelvis and often a shared sacrum. The vertebral column may also be partially fused, depending on the extent of the conjoining.

Muscular and Nervous Systems

The muscular system in the pelvic region is often shared, which can complicate movement and function. The nervous system may also be interconnected, particularly in cases where the spinal cord is involved.

Diagnosis

Ischiopagus twins are typically diagnosed through prenatal imaging techniques such as ultrasound and magnetic resonance imaging (MRI). These imaging modalities help in assessing the extent of fusion and organ sharing, which is crucial for planning potential surgical interventions.

Management and Treatment

The management of ischiopagus twins involves a multidisciplinary approach, including pediatric surgery, orthopedics, and neonatology.

Surgical Separation

Surgical separation of ischiopagus twins is a complex procedure that requires careful planning and coordination among various medical specialties. The decision to separate is based on the extent of organ sharing, the potential for independent survival, and the overall health of the twins.

Non-Surgical Management

In cases where surgical separation is not feasible, non-surgical management focuses on improving the quality of life for the twins. This may include physical therapy, occupational therapy, and adaptive equipment to aid mobility and daily activities.

Prognosis

The prognosis for ischiopagus twins varies depending on the extent of fusion and the presence of associated anomalies. Successful surgical separation can lead to improved outcomes, but the complexity of the condition often presents significant challenges.

Related Pages

• Conjoined twins
• Pelvis
• Surgical separation of conjoined twins