Siamese twin with unusual congenital defects operated upon

The doctors of Paediatric Surgery department at Chittagong Medical College and Hospital (CMCH) performed an operation on a conjoined twin with unusual congenital defects here yesterday.
The twin with separate limbs as well as separate respiratory and intestines are joined together below a common navel. One of them has separate legs, while the other, which appears to be a female one, got the legs joined at thighs and feet.
What make the babies most unusual are absence of anus or any other excretory organs that remain to be detected and separated, said the doctors.
A team of doctors led by renowned paediatric surgeon Prof Dr Tahmina Banu, also the head of the department, performed the emergency operation on the twin to make anal and urethral openings.
The twin of Merry Dash, 21, and Mintu Das, 27, a couple of north Kolaujan under Lohagara upazila in the district, took birth at Lohagara Health Complex at 7:00am on Saturday.
Though the conjoined twin could be delivered normally, the unusual congenital defects prompted the doctors of the health complex to contact the CMCH immediately. The twin arrived at the hospital in the evening.
Immediately after the twin were brought to CMCH, the doctors of paediatric department left no time to take all preparations to go for the emergency surgery to develop anus and other excretory organs (penis and vagina).
“Such conjoined babies, which are termed as Siamese twin, are born one in a fifty thousand. And the twin we have here are most unusual since they lack in anus and urethral openings,” said Prof Tahmina while talking to this correspondent at CMCH the same day.
“In medical science, this condition might be termed as Omphalo-Ischiopagus Tripus Recto-bladder Neck Fistula,” she added.
“The babies had separate small intestine. But, they shared a common large intestine that opened into a single urinary bladder. One of the babies that looked like female had its heart in the right side and did not have any urethral channel. The other baby had urethra like male.
“We have made two anus and one urethral opening for the babies in the surgery that took some three hours since 11:30am,” informed the surgeon.
“Both the babies now look fine. But, if the single urethral opening cannot help them we would construct two separate excretory or reproductive organs - penis and vagina -- for them during the operation needed to separate them,” she noted.
Though it was surprising that the delivery was normal and both the babies were in good health during their birth, their condition started deteriorating since the morning as they don't have openings of excretory organs,” she said.
Prof Tahmina said, “The twin babies are now under our close observation. A lot of tests and investigations have to be done on them before going for the rare operation to separate them.”
“Even before going for the tests and investigation, we would have to wait for some three months, she mentioned.
The surgeon further said, “It may take us six months to one year before we go for the rare operation upon the twin after consulting reputed surgeons from home and abroad.”