At three and a half months of age, progressive feeding intolerance in the infant led to the identification of a small-bowel stricture requiring surgical resection with primary anastomosis. The infant was discharged home at six months of age. The mother's postoperative course was uneventful, and she was discharged home on day 4 after delivery. Discussion Conjoined twins are classified according to the location of the tissue that links the twins. Twenty-eight percent of conjoined twins are classified as thoracoomphalopagus.
Anatomical abnormalities are common among conjoined twins.
The pump twin usually develops normally but is vulnerable to intrauterine congestive heart failure and premature delivery because of polyhydramnios. The perfused twin usually has aplasia or hypoplasia of the heart, head, and arms and therefore dies immediately after birth. Mortality among pump twins ranges from 50 percent to 75 percent, with most deaths due to intrauterine cardiac failure or complications of prematurity. Paradoxically, the unique vascular configuration in this case may have resulted in improved flow of oxygenated blood to the cephalad region of the acardiac twin, which may explain the absence of aplasia or hypoplasia in the head and arms of that twin. Survival depends on the type and extent of joining and on the presence or absence of associated anomalies.