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

Authors

John-Paul Sara, New York Medical College
Ashley Kydes
Olena Pryjdun, New York Medical College
Michael Jacoby, New York Medical CollegeFollow
Whitney McBride, New York Medical College
Samir Pandya, New York Medical CollegeFollow
Samuel M. Barst, New York Medical CollegeFollow

DOI

10.1213/XAA.0000000000000739

Journal Title

A&A Practice

First Page

71

Last Page

72

Document Type

Case Report

Publication Date

August 2018

Department

Anesthesiology

Keywords

Anesthesia, Laparoscopy, Pneumoperitoneum, Twins, Conjoined

Disciplines

Medicine and Health Sciences

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.

Recommended Citation

Sara, J., Kydes, A., Pryjdun, O., Jacoby, M., McBride, W., Pandya, S., & Barst, S. (2018). Anesthesia for Pygopagus Conjoined Twins During Single-twin and Simultaneous Pneumoperitoneum: A Case Report. A&A Practice, 11 (3), 71-72. https://doi.org/10.1213/XAA.0000000000000739