title: Thoraco-omphalopagus asymmetric conjoined twins: report of a case and complete review of the literature.
abstract: Thoraco-omphalopagus asymmetric conjoined twinning is a rare condition in which a grossly defective foetus (the parasite) is attached to the thorax and upper abdomen of the main foetus (the autosite). We describe a case of thoraco-omphalopagus asymmetric conjoined twins in which the autosite had an associated large-diameter omphalocoele that was successfully separated at our institution. Reconstruction of the resulting abdominal-wall defect was performed using a flap from the gluteal region and the proximal portion of the inferior limb of the parasite, which is demonstrated. In addition, a review of all previously published cases is presented, showing that overall positive results can be obtained in treating this condition and that the presence and degree of cardiac involvement have a major influence on the prognosis.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, Brazil; Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP 13083-887, Cx, Postal 6111 Campinas, São Paulo, SP, Brazil. Electronic address: davicalderoni@yahoo.com.br.
authors.forename: Davi Reis
authors.initials: DR
authors.lastname: Calderoni
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, Brazil; Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP 13083-887, Cx, Postal 6111 Campinas, São Paulo, SP, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: Mizukami
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, Brazil; Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP 13083-887, Cx, Postal 6111 Campinas, São Paulo, SP, Brazil.
authors.forename: Paulo Henrique Facchina
authors.initials: PH
authors.lastname: Nunes
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas - Unicamp, Campinas, Brazil; Rua Tessália Vieira de Camargo, 126, Cidade Universitária 'Zeferino Vaz', CEP 13083-887, Cx, Postal 6111 Campinas, São Paulo, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Kharmandayan
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D035441:Thoracic Wall / Q000601:surgery*; D014428:Twins, Conjoined / Q000601:surgery*
keywords: Congenital defects; Conjoined twins; Omphalocoele; Reconstructive surgical procedure; Surgical flap