Anesthesia for Pygopagus Conjoined Twins During Single-Twin and Simultaneous Pneumoperitoneum: A Case Report : A&A Practice

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

Sara, John-Paul MD*; Kydes, Ashley MD*; Pryjdun, Olena MD*; Jacoby, Michael MD*; McBride, Whitney MD†; Pandya, Samir MD†; Barst, Samuel MD*

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A & A Practice 11(3):p 71-72, August 1, 2018. | DOI: 10.1213/XAA.0000000000000739

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.

Copyright © 2018 International Anesthesia Research Society

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