Öz
Parapagus twins are reported very rarely in the literature. The incidence is estimated one in 200 000 live birth. The incidence in our country isn’t known. Because of the mother who was 36 years old, in the 8. pregnancy, the 8. and 9. live birth babie, who have dispnea after birth, were sent to in our hospital. Twins that their bodies are joined anterolaterally, have two complete heads, 3 hands and 3 feet, one anus and suspected genitelia. Heart beat of left sided twin was 137/minute and the saturation was 85% and right sided twin’s was 135/minute and 86%. Cranial ultrasonographic examination and magnetic resonance imaging were normal. Abdominal ultrasonography and magnetic resonance imaging showed one liver, one spleen, 3 kidney and one bladder. On echocardiographic examination, there were 2 ventricles, 2 atriums in right sided twin and one ventricle, one atrium in left sided. Complete atrioventricular septal defect, pulmonary stenosis and transposition of the great arteries were seen in right sided twin. We didn’t saw second ventricle in left sided twin. Posterior wall of right baby’s left ventricle and left baby’s single ventricle’s wall were fused. There was fusion on atrial and ventricular levels. We want to share the conclusions of echocardiographic examination of parapagus twins who were rarely seen and had different complex congenital heart disease.
Anahtar Kelimeler
Kaynakça
- Oostra RJ, Keulen N, Jansen T, van Rijn RR. Absence of the spleen in conjoined twins: A diagnostic clue of laterality defects? Radiological study of historical specimens. Pediatr Radiol 2012; 42: 653-9. Spitz L, Kiely EM. Experience in the management of conjoined twins. Br J Surg 2002; 89: 1188-92.
- Synhorst D, Matlak M, Roan Y. Separation of conjoined twins joined at the right atria. Am J Cardiol 1979; 43: 662-5.
- Cywes S, Millar AJ, Rode H. Conjoined twins: The cape town experience. Pediatr Surg Int 1997; 12: 234-48.
- Andrews RE, McMahon CJ, Yates RWM, Cullen S, de Leval MR, Kiely EM, Spitz L, Sullivan ID. Echocardiographic assessment of conjoined twins. Heart 2006; 92: 382-7.
- Tansel T, Yazicioğlu F. Cardiac and other malformations in parapagus twins. Arch Gynecol Obstet 2004; 269: 211-3.
Öz
Özet
Parapagus ikizler literatürde son derece nadir olarak bildirilmiştir. Tahmin edilen sıklığı iki yüz bin doğumda birdir. Ülkemizdeki sıklığı ise tam olarak bilinmemektedir. Otuz altı yaşındaki annenin 8’inci gebeliğinden 8’inci ve 9’uncu canlı doğum olarak doğan bebeklerin doğum sonrası solunum sıkıntıları olması nedeni ile hastanemize gönderildiler. Vücutları anterolateral olarak birleşmiş ikizlerin iki başı, 3 eli ve 3 ayağı, bir anal açıklığı ve şüpheli genital yapısı vardı. Soldaki bebeğin kalp tepe atımı 137/dak. ve satürasyonu %85, sağdaki bebeğin sırası ile 135/dak. ve %86 idi. Kraniyal ultrasonografik inceleme ve magnetik rezonans görüntüleme normaldi. Abdominal ultrasonografi ve magnetik rezonans görüntülemede ise bir karaciğer, bir dalak, 3 böbrek ve bir mesane görüldü. Yapılan ekokardiyografik incelemede sağdaki bebeğin iki ventrikül, iki atriyumunun, soldakinin ise tek ventrikül ve tek atriyumunun olduğu, sağdaki bebekte komplet atriyoventriküler septal defekt, pulmoner stenoz ve büyük arterlerin transpozisyonu bulunduğu görüldü. Soldaki bebeğin ikinci ventrikülü görülemedi. Sağdaki bebeğin sol ventrikül arka duvarı ile soldaki bebeğin ventrikül duvarı ortaktı. Atriyum ve ventrikül düzeyinde füzyon olduğu düşünüldü. Nadir görülen bir durum olan ve literatürde daha önce bildirilmemiş, farklı kompleks doğumsal kalp hastalığı saptanan parapagus ikizlerin ekokardiyografik inceleme sonuçlarını paylaşmak istedik.
Anahtar sözcükler: Doğumsal kalp hastalığı, ekokardiyografi, kardiyak cerrahi
Abstract
Parapagus twins are reported very rarely in the literature. The incidence is estimated one in 200 000 live birth. The incidence in our country isn’t known. Because of the mother who was 36 years old, in the 8. pregnancy, the 8. and 9. live birth babie, who have dispnea after birth, were sent to in our hospital. Twins that their bodies are joined anterolaterally, have two complete heads, 3 hands and 3 feet, one anus and suspected genitelia. Heart beat of left sided twin was 137/minute and the saturation was 85% and right sided twin’s was 135/minute and 86%. Cranial ultrasonographic examination and magnetic resonance imaging were normal. Abdominal ultrasonography and magnetic resonance imaging showed one liver, one spleen, 3 kidney and one bladder. On echocardiographic examination, there were 2 ventricles, 2 atriums in right sided twin and one ventricle, one atrium in left sided. Complete atrioventricular septal defect, pulmonary stenosis and transposition of the great arteries were seen in right sided twin. We didn’t saw second ventricle in left sided twin. Posterior wall of right baby’s left ventricle and left baby’s single ventricle’s wall were fused. There was fusion on atrial and ventricular levels. We want to share the conclusions of echocardiographic examination of parapagus twins who were rarely seen and had different complex congenital heart disease.
Keywords: Congenital heart disease, echocardiography, cardiac surgery
Anahtar Kelimeler
Kaynakça
- Oostra RJ, Keulen N, Jansen T, van Rijn RR. Absence of the spleen in conjoined twins: A diagnostic clue of laterality defects? Radiological study of historical specimens. Pediatr Radiol 2012; 42: 653-9. Spitz L, Kiely EM. Experience in the management of conjoined twins. Br J Surg 2002; 89: 1188-92.
- Synhorst D, Matlak M, Roan Y. Separation of conjoined twins joined at the right atria. Am J Cardiol 1979; 43: 662-5.
- Cywes S, Millar AJ, Rode H. Conjoined twins: The cape town experience. Pediatr Surg Int 1997; 12: 234-48.
- Andrews RE, McMahon CJ, Yates RWM, Cullen S, de Leval MR, Kiely EM, Spitz L, Sullivan ID. Echocardiographic assessment of conjoined twins. Heart 2006; 92: 382-7.
- Tansel T, Yazicioğlu F. Cardiac and other malformations in parapagus twins. Arch Gynecol Obstet 2004; 269: 211-3.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Haziran 2014 |
| Yayımlandığı Sayı | Yıl 2014Cilt: 36 Sayı: 2 |