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<p>Heteropagus twins is a rare congenital anomaly which is usually characterized by a malformed parasitic twin attached to a relatively healthy twin. Here we report a case of a 4-month-old male child which had external accessory limbs with rudimentary phallus attached to the left side of pelvis, a reducible inguinal hernia and undescended testes. On imaging we also found a retroperitoneal mass with intestinal elements. We thus performed a diagnostic laparoscopy where we found that the herniated bowel originated from the parasitic twin. Thus, in our case, laparoscopy helped us in planning definitive surgical management and also to locate undescended testes in the abdomen. We excised both the external and internal parasitic components and also performed orchidopexy and excision of anterior lumbosacral lipomyelomeningocele with dura closure. Postoperative follow up was uneventful, and is on regular follow-up. Based on our review, this appears to be the first reported case of ischiopagus twins with an internal parasitic intestinal component with rudimentary testes in autosite which is presenting as an inguinal hernia in the autosite, and also associated with anterior lipomyelomenigocele, accessory vertebra and ribs, and an undescended testis in the autosite. Our current study also highlights the diagnostic and therapeutic role of laparoscopy in such complex congenital anomalies and its importance in better surgical planning.</p>

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Laparoscopic management of heteropagus twins with internal component, inguinal hernia, undescended testes, anterior lipomyelomeningocele, accessory vertebra and ribs

  • 期刊论文

  • 发表日期：

    2026年1月22日

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  • Praveen Mathur,
  • Aditya J. Baindur,
  • Ankita Gupta,
  • Ramesh Chand Tanger,
  • Neelam Dogra,
  • Anu Bhandari,
  • Vinayak Rengan

摘要

Heteropagus twins is a rare congenital anomaly which is usually characterized by a malformed parasitic twin attached to a relatively healthy twin. Here we report a case of a 4-month-old male child which had external accessory limbs with rudimentary phallus attached to the left side of pelvis, a reducible inguinal hernia and undescended testes. On imaging we also found a retroperitoneal mass with intestinal elements. We thus performed a diagnostic laparoscopy where we found that the herniated bowel originated from the parasitic twin. Thus, in our case, laparoscopy helped us in planning definitive surgical management and also to locate undescended testes in the abdomen. We excised both the external and internal parasitic components and also performed orchidopexy and excision of anterior lumbosacral lipomyelomeningocele with dura closure. Postoperative follow up was uneventful, and is on regular follow-up. Based on our review, this appears to be the first reported case of ischiopagus twins with an internal parasitic intestinal component with rudimentary testes in autosite which is presenting as an inguinal hernia in the autosite, and also associated with anterior lipomyelomenigocele, accessory vertebra and ribs, and an undescended testis in the autosite. Our current study also highlights the diagnostic and therapeutic role of laparoscopy in such complex congenital anomalies and its importance in better surgical planning.