• A&A practice · Aug 2018

    Case Reports

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

    • John-Paul Sara, Ashley Kydes, Olena Pryjdun, Michael Jacoby, Whitney McBride, Samir Pandya, and Samuel Barst.
    • From the Departments of Pediatric Anesthesiology.
    • A A Pract. 2018 Aug 1; 11 (3): 71-72.

    AbstractWe 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.

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