Conjoined Twins: The Flip Side

The twins were referred to us for further management after regional pediatric surgical department showed its inability to deal with the case. The family was not counseled and thee transfer was unsupervised. The referring department also made no contact with our team. Babies were brought in, by maternal uncle. Mother did not accompany the newborns, as she was unwell. At arrival babies were not in good condition. One of the twins was having respiratory distress. Immediate resuscitative measures were taken and neonatal care provided. Within hours the decision was made to intubate and mechanically ventilate the pair. However at that time only one ventilator was available, therefore twin 2, who was in critical condition, ventilated. The clinical condition stabilized. Further imaging studies like x-rays, ultrasound and echocardiography were carried out to understand anatomy of fusion and identify associated anomalies.