title: Ischemic ileal perforation in the donor of monochorionic twins complicated by twin-twin transfusion syndrome.
abstract: Twin-twin transfusion syndrome (TTTS) carries a significant risk of perinatal morbidity and mortality. Serial amnioreduction and fetoscopic laser photocoagulation have decreased perinatal mortality, thereby shifting attention towards short-term and long-term morbidity. Most morbidity occurs within the central nervous system. Ischemic lesions, however, such as congenital skin loss and limb necrosis may occur anywhere in the vasculature of recipient twins. Ischemia may also occur during serial amnioreduction and fetoscopic laser photocoagulation. We report a case of ileal perforation in the donor twin of untreated TTTS. Histopathology showed a focal area of erosion, possibly from ischemia. We also discuss the clinical features of ischemic intestinal complications of TTTS and review the literature.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Chuo-ku, Fukuoka, Japan. tsukimori.k@fukuoka-child.jp
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Tsukimori
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yumoto
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumoto
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kondo
authors.forename: Katsuo
authors.initials: K
authors.lastname: Sueishi
authors.forename: Norio
authors.initials: N
authors.lastname: Wake
mesh_terms: D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000209:etiology* / Q000503:physiopathology; D005330:Fetofetal Transfusion / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007082:Ileum / Q000098:blood supply* / Q000473:pathology; D007416:Intestinal Perforation / Q000209:etiology* / Q000503:physiopathology; D007511:Ischemia; D011247:Pregnancy