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