Two Souls, One and a Half Bodies

siamesetwins.jpgConjoined twins are monozygotic multiples that do not separate from each other due to incomplete division of fertilized ovum. The individuals can be connected at a certain point of the body and may share tissue, organ and limb. Like all monozygotic twins, conjoined twins are also of same sex (either both boys or both girls).It is estimated that seventy percent of conjoined twins are females; there is no identified reason for it. Some doctors believe that more female twins are conceived and some believe that more female conjoined sets survive the pregnancy. Birth of conjoined twins is fairly a rear occurrence; the statistical count is one in every eighty five thousand births. Even though monozygotic twinning are not affected by heredity, ethnicity, maternal age or any other factor, more of the conjoined examples are seen in Africa and Asia than in Europe and America. Conjoined twins are classified according to the place of the body where the twins are connected. They are: Cephalopagus (upper trunk and head), Cranipagus (head), Epholothoracopaqus (brain, head and chest), Omphalopagus (trunk, front/back), Thorapacqus (chest), Parapaqus (lower body), Ischipagus (lower body, front back). When twins share an extensive connection over several areas then the duplicated part is named, for example, Dicephalus for twins with two heads and one body. Earliest dated conjoined history is from the year 945 AD; conjoined twin brothers of Armenia were brought to

Constantinople for treatment. According to Moche culture of ancient

Peru depiction of conjoined twins dates back to 300 AD. The most famous pair of twins was Chang and Eng Bunker, born in

Siam, they were joined by only a small band of cartilage at the sternum. The boys were three-quarters Chinese and known in their native village as ‘The Chinese Twins’ and even the name Siamese Twins originated from them. In 1874, Chang, the stronger, more stubborn of the twins and also a heavy drinker, contracted pneumonia. This was worsened by a carriage trip in the rain between two farms. He died rather suddenly during a night of January the 17th. Eng awoke to find his brother dead, and he called for his wife and children to attend to him. According to some stories, the family sent for a doctor to perform an emergency separation, but Eng had died by the time the doctor arrived. By other accounts, Eng refused to be separated from his dead brother. He died three hours later. In 20th and 21st century, we have seen many cases of conjoined twins but the latest one is of Lakshmi Tamta, She had four arms and four legs, resulting from a joining at the pelvis with a headless, undeveloped twin. She underwent a successful surgery in November this year in

India. Surgeries to separate conjoined twins may range from relatively simple to extremely complex, depending on the point of attachment and the internal parts that are shared. Most cases of separation are extremely risky and life-threatening. In some cases it is seen that, while separating the twins, the surgery results in the death of one or both of the twins, particularly if they are joined at the head. Lakshmi’s surgery was successfully done by Dr Sharan Patil and thirty other surgeons at Saprsh hospital. Anu Prakash