Omphalopagus conjoined twins separation during coronavirus disease-19 pandemic era: A case report.
Int J Surg Case Rep
; 84: 106150, 2021 Jul.
Article
in English
| MEDLINE | ID: covidwho-1293857
ABSTRACT
INTRODUCTION AND IMPORTANCE Conjoined twin is a rare congenital anomaly characterized by a fusion of certain anatomical structures. Coronavirus-19 (COVID-19) is a new emerging infectious respiratory disease affecting worldwide and potentially leads to acute respiratory distress (ARDS) in children. COVID-19 has reconstructed the healthcare system, including surgical care and decision-making. CASE PRESENTATION Herein we describe a surgical separation of 2.5 months old omphalopagus conjoined twins, with one of them (Baby A) presenting COVID-19-associated respiratory distress, as well as the challenges faced during the preparation and the execution of the complex surgical procedure. CLINICAL DISCUSSION:
Baby A underwent antiviral therapy, oxygen supplementation, and ventilation in the ICU, while baby B remained stable and confirmed negative for SARS-CoV-2. The separation surgery was conducted after baby A had become clinically stable. Defect closure and reconstruction were accomplished. At one week follow-up, Baby A died of lung infection, while baby B remained well after one year.CONCLUSION:
The complexity of surgical separation requires careful planning by a multidisciplinary team. Surgical separation of conjoined twins during the pandemic era has not been reported much in the literature, more reports are required to provide further insight.
ARDS, acute respiratory distress syndrome; CDC, Centers for Disease Control and Prevention; COVID-19; COVID-19, coronavirus disease-19; CPAP, continuous positive airway pressure; CT-scan, computed tomography-scan; CUSA, cavitron ultrasonic surgical aspirator; Case report; Children; Conjoined twins separation; ECMO, extracorporeal membrane oxygenation; HCP, healthcare providers; HFN, high flow nasal; HFOV, high-frequency oscillation ventilation; ICU, intensive care unit; IVC, inferior vena cava; MRI, magnetic resonance imaging; MRSA, methicillin-resistant Staphylococcus aureus; NPWT, negative pressure wound therapy; ORC, oxidized regenerated cellulose; Omphalopagus conjoined twins; PCR, polymerase chain reaction; PDA, patent ductus arteriosus; PDS, polydioxanone suture; PICU, pediatric intensive care unit; POD, post-operative day; PPE, personal protective equipment; SCARE, surgical case report; WHO, World Health Organization; cm, centimeter; lpm, litres per minute
Full text:
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Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Cohort study
/
Prognostic study
Language:
English
Journal:
Int J Surg Case Rep
Year:
2021
Document Type:
Article
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