Conjoined twins

Conjoined twins (also double malformation ) denote an aberration, remain physically connected with each other in identical twins during their intra- uterine development and after birth.

In monozygotic ( monozygotic ), monochorionic - monoamniotic twins the fertilized egg splits into two independent embryonic rudiments. In an incomplete Durchschnürung the embryo blasts in late-stage development of the blastocyst after 13 days after fertilization, the two fetuses remain connected.

The statistical probability of a double malformation is between 1:60,000 and 1:200,000. This corresponds to a frequency in monozygotic twin pregnancies of 1:300. However, since an average of three out of ten Siamese twins die prenatally, a Siamese twins is only about one million live births. If it is known that it is a Siamese twins and the pregnant woman or the parental couple decides not to have an abortion, the birth is usually by Caesarean section performed in order to keep the health risks for both mother and child as small as possible.

Characteristics

The compound can both reach up to the internal organs or affect only tissue outside. So it may happen that a siamese twin pair has only a heart or lung.

In medicine, the adhesion is differentiated according to the type and extent. Adhesions can occur in different parts of the body:

• Chest ( thoracopagus, about 70 % of cases)
• Hip area ( Ischiopagus, about 5 % of cases)
• Head ( Craniopagus ( Kephalopagus ), less than 2% of cases ) Special Form: Dizephalie: single body with two heads
• Special Form: Janiceps (after the two-faced god Janus ): at the head coalesced Siamese twins, whose faces look in opposite directions

However, someone may not necessarily be a siamesicher twin with, for example, two faces. There may also be cases of Diprosopus.

If a separation is possible and necessary within the first three weeks after delivery, the mortality rate is 50% on average, while the survival rate is between the fourth and 14th week at 90 %. The (pre- and post-natal ) prognosis is, however, always depends on the type and extent of fusion of the children.

Parasitic twin

The division does not have to be always symmetrical. Designed for example, the cell material of one twin only incomplete, it can also lead to asymmetric (or parasitic ) Double malformations. The advanced child, in this case called also autosite, carries the child less developed, the " parasites " on or in the body. In extreme cases, the child is less developed may consist only of a tumor-like cell clusters, which, however, must be distinguished differential diagnosis against the teratoma (Greek teras, monster, freak '), contains a germ cell tumor, the shares of all three germ layers.

Separation

Depending on the nature and extent of the connection can be a surgical separation of the twins. In this case, some conditions must be met:

• The twins must each possess all the vital organs.
• The vital processes such as metabolism and respiration may not be too complicated intertwined (eg, common bloodstream or more only individually existing organs like the heart and liver).

By September 2004, 30 grown together at the skull children survived a separation, 17 of them were hampered after the procedure.

Famous cases

Among the first traditions about Siamese twins counts the legend of Mary and Eliza Chulkhurst from Biddenden, which were known as the Biddenden Maids, and to have lived in the early 12th century.

Lazarus and Joannes Baptista Colloredo traveled to many countries in the 17th century. Lazarus is said to have earned his parasitic twin brother a lot of money.

The name comes from the Siamese twins Chang and Eng Bunker twins (1811-1874), German is the name usually given instead Bunkes bunker. The two brothers were (now Thailand) born in Siam, under the name The Siamese twins were known as a fairground attraction and gave the name of this malformation. The brothers married the two sisters Adelaide and Sarah Yates and begot with them a total of 18 children ( According to other sources, 11 children ). Both brothers died one after only a few hours.

However, Ritta and Christina Parodi could not be publicly displayed, although the interest of the public and especially the medicine was great. The two little girls died in childhood.

Giovanni Battista and Giacomo Tocci were born in 1877 and placed at the age of four weeks to show. After they had come of age, they retreated behind the high walls of her mansion back in Italy, never to be again exposed to prying eyes.

The 1908 -born sisters Daisy and Violet Hilton were fused to the pelvis and back. Your mother bought shortly after birth, they were issued as other Siamese twins at fairs. As adults, they performed their show career continued on his own and played in two films.

Notoriety reached the two 29 -year-old sisters Ladan and Laleh Bijani from Iran (born 17 January 1974), which had grown together at the top and were separated from 7 July 2003, an elaborate operation of a group of doctors in Singapore. Shortly after the separation Ladan Bijani died a few hours later her sister Laleh. Cause of death was, according to the doctors circulatory failure due to excessive blood loss during surgery.

Conjoined twins in animals

Lack of separation of two identical twins also occurs in animals. Except in the case of domestic animals, in which the owner cares about, this usually leads to a repudiation of the twins by the mother in the case of mammals, and thus to premature death.

Most common form is the Dicephalie that is, two completely from the neck forth or until the face and brain duplicate existing heads with common trunk and extremities common. While it is usually assumed in the former such cases in humans ( dicephalus dipus ) of two individuals, is inconsistently spoken in animals in such cases from an animal with two heads. The Dicephalie is not confined to mammals, but even among other things, in amphibians and reptiles (eg snakes) was observed.

However, to be distinguished from the Dicephalie is the cause attributable to other causes malformation Diprosopus, ie the Zweigesichtigkeit with a single head, torso and set of limbs. Even this deformity occurs both in humans (rarely documented ) and animals. A certain notoriety has it in the U.S. over the past ten years, the pig Ditto obtained which, however, as a result of simultaneous seizure and died breathing through the two existing mouths.

Conjoined twins in multiple births ( twins next )

Basically not excluded are also Siamese multiple births with more than two parties. However, since already triplet births are relatively rare, are those little documented with incomplete multiples even more rare and correspondingly in the literature.

Siamese Twins in Art

• Bobby Farrelly and Peter Farrelly attacked the subject in 2003 in a comedy titled Stuck - on Stuck on You.
• The Mystery television series The X-Files Act - The Files addresses the issue of parasitic Siamese twin Brotherhood in the episode The Circus ( Episode 20 of Season 2 ).
• The in the episode " Rose and Raven Rosenberg " the series Nip / Tuck ( Season 2, Episode 9) occurring Siamese twins are represented by Reba and Lori Schappell. The two sisters oppose a separation from each other strictly.
• In the novel Job's brothers Rebecca Gablé describes the life of a Siamese twin pair in the English Middle Ages. They are held here by the superstitious population alternately for luck or godless monstrosities.