A dicephalus calf: anatomical, pathological and radiographic aspects

Congenital malformations are morphofunctional abnormalities of tissues and organs that can occur during embryonic or fetal development in all animal species. Among these, dicephalus is characterized by the development of an individual with two heads and two necks, due to the total duplication of facial, cranial, and brain structures. Reports of dicephalus in cattle are scarce and do not normally emphasize radiographic and bone anatomy characteristics. The objective was to describe a case of a stillborn dicephalus calf. The duplication of the head, brain, neck, and two thoracic vertebral columns, isolated from each other, with 13 vertebrae each was verified radiographically. There were 13 pairs of ribs, the ones on the right side articulated with the thoracic spine on the right and the left ones with the spine on the left. Caudally at T13, there was only one lumbar spine, sacral and coccygeal. In the ventrodorsal projection, L1, L2, L3, and L6 had the shape of a butterfly (suggestive of hemivertebrae). At necropsy, in addition to craniocervical and spinal morphological changes, collapsed lungs, duplication of the heart with anastomosis between the aortic arches of the hearts, and duplication of the upper digestive tract were observed. Additionally, there was arthrogryposis of the pelvic limbs. Corpse maceration, followed by the skeletal assembly, showed the bone changes previously observed and confirmed the suspicion of hemivertebrae.

A dicephalus calf: anatomical, pathological and radiographic aspects

Congenital malformations are morphofunctional abnormalities of tissues and organs that can occur during embryonic or fetal development in all animal species. Among these, dicephalus is characterized by the development of an individual with two heads and two necks, due to the total duplication of facial, cranial, and brain structures. Reports of dicephalus in cattle are scarce and do not normally emphasize radiographic and bone anatomy characteristics. The objective was to describe a case of a stillborn dicephalus calf. The duplication of the head, brain, neck, and two thoracic vertebral columns, isolated from each other, with 13 vertebrae each was verified radiographically. There were 13 pairs of ribs, the ones on the right side articulated with the thoracic spine on the right and the left ones with the spine on the left. Caudally at T13, there was only one lumbar spine, sacral and coccygeal. In the ventrodorsal projection, L1, L2, L3, and L6 had the shape of a butterfly (suggestive of hemivertebrae). At necropsy, in addition to craniocervical and spinal morphological changes, collapsed lungs, duplication of the heart with anastomosis between the aortic arches of the hearts, and duplication of the upper digestive tract were observed. Additionally, there was arthrogryposis of the pelvic limbs. Corpse maceration, followed by the skeletal assembly, showed the bone changes previously observed and confirmed the suspicion of hemivertebrae.(AU)

Diprosopus: Systematic review and report of two cases.

BACKGROUND: Diprosopus is a subtype of symmetric conjoined twins with one head, facial duplication and a single trunk. Diprosopus is a very rare congenital anomaly. METHODS: This is a systematic review of published cases and the presentation of two new cases born in Argentina. We estimated the prevalence of conjoined twins and diprosopus using data from the National Network of Congenital Anomalies of Argentina (RENAC). RESULTS: The prevalence of conjoined twins in RENAC was 19 per 1,000,000 births (95% confidence interval, 12-29). Diprosopus prevalence was 2 per 1,000,000 births (95% confidence interval, 0.2-6.8). In the systematic review, we identified 31 diprosopus cases. The facial structures more frequently duplicated were nose and eyes. Most frequent associated anomalies were: anencephaly, duplication of cerebral hemispheres, craniorachischisis, oral clefts, spinal abnormalities, congenital heart defects, diaphragmatic hernia, thoracic and/or abdominal visceral laterality anomalies. One of the RENAC cases and three cases from the literature had another discordant nonmalformed twin. CONCLUSION: The conjoined twins prevalence was similar to other studies. The prevalence of diprosopus was higher. The etiology is still unknown. The presence of visceral laterality anomalies may indicate the link between diprosopus and the alteration or duplication of the primitive node in the perigastrulation period (12-15 days postfertilization). Pregnancies of more than two embryos may be a risk factor for diprosopus. Given the low prevalence of this defect, it would be useful to perform studies involving several surveillance systems and international consortiums. Birth Defects Research (Part A), 2016. © 2016 Wiley Periodicals, Inc. Birth Defects Research (Part A) 106:993-1007, 2016. © 2016 Wiley Periodicals, Inc.

Dicephalus dibraqui dipus / Dicephalus dibraqui dipus

Uno de los estados más interesantes y a la vez complejos a la hora de enfrentar desde el punto de vista médico de los embarazos múltiples son los gemelos siameses, o simplemente la fusión anatómica parcial en grado variable de sus estructuras orgánicas. En el presente artículo se presentan los datos generales y obstétricos más relevantes de uno de estos embarazos, ocurrido en la Isla de la Juventud en el año 2006, se convirtió en el primer embarazo de este tipo del que se tiene conocimiento en nuestro territorio. El caso resulta interesante a la vez por lo poco común que resultan muchos de los hallazgos encontrados en estos gemelos, en comparación con casos similares recogidos en la literatura, la no concomitancia de este caso con factores de riesgo comunes y la certeza del diagnóstico imagenológico

One of more interesting and at the same time complex challenges the multiple pregnancies is the presence of Siamese twins, or simply, a varying degree partial anatomic fusion of its organic structures. In present paper are included the more relevant general and obstetric data from one of these pregnancies occurred in Isla de la Juventud en 2006, becoming the first pregnancy of this type in our country. This case is interesting too by the unusual findings present in these twins compared to other similar cases present in the literature, the non-concomitance of this case with common risk factors and the accuracy of imaging diagnosis

Nosología actual de las duplicaciones embrionarias / Embryonic duplication. A nosologic update

Las formas anormales de gemelaridad constituyen un impactante fenómeno biológico y cuentan con una larga historia de concepciones erróneas, escaso conocimiento y una amplia y confusa sinonimia. En esta revisión se presenta la nosología actual de las duplicaciones embrionarias monocigóticas con énfasis en los gemelos unidos (GU), mediante la cual casi la totalidad de los casos de GU pueden ser adecuadamente diagnosticados. Dicha clasificación se basa en la orientación que guardan los discos embrionarios en etapas tempranas del desarrollo, resultando los 8 sitios de uniones conocidas tanto para las formas simétricas, parasitarias o ambas de GU: toracópagos, onfalópagos, cefalópagos, isquiópagos, parápagos, pigópagos, craneópagos y raquípagos. Además, se plantean las bases teóricas propuestas para el origen de las duplicaciones embrionarias, su epidemiología estimada a partir de alrededor de 1,300 reportes y su diagnóstico prenatal y diferencial. El entender la naturaleza aleatoria del fenómeno de gemelaridad, nos conduce a aceptar las limitaciones y avances en su tratamiento.

Aspectos eletrencefalográficos em gêmeos conjugados - relato de um caso / Eletroencephalographic aspects in conjoined twins: report of a case

O autor relata alguns achados peculiares do Eletroencefalograma (EEG) de um raro caso de gêmeos conjugados, o tipo "Dicephalus dibrachius"

Gemelos unidos (Bicéfalos tribrachius). Diagnóstico prenatal y manejo obstétrico: reporte de un caso / Conjoined twins (Dicephalous tribrachius). pre-natal diagnosis and obstetrical management. a case report

El diagnóstico prenatal de gemelos unidos bicéfalos por ultrasonografía, una revisión de esta patología y las implicaciones de su manejo obstétrico son descritas en este caso clínico

Craniópagos. Separación frustra: consideraciones generales / Craniopagus. Unsuccesful separation: general considerations

Se expone el primer caso de craniópagos del Hospital de Niños J.M. de los Ríos, separados quirúrgicamente pero con muerte de ambas criaturas a los 4 días por coagulopatía intrvascular y a los 9 días después de separados con coordinación central, con personal total de 32 participantes. Hubo 2 ejercicios previos con muñecos tamaño natural, con todas las lineas anestesicas, dos quirúrgicas separadas, ejercicios de rotación con las lineas y monitores conservados de una posición de decúbito a la otra y los movimientos de separación. Hubo experiencia anestésica previa con los expansores de piel que mostraron la acción independiente farmacológica de un paciente en el otro. lo crítico de la arteria del B sobre el A y las modificaciones posturales de altura de la mesa que eran necesario para corregir la hipotensión. Se revisaron otros aspectos sobre tan rara patología con una incidencia de 4 a 6 por cada 10 millones de nacimientos

[Hemodynamic and angiocardiographic assessment of thoracopagus twins for surgical separation purposes]. / Evaluación hemodinámica y angiocardiográfica de gemelos toracópagos con finalidad de separación quirúrgica.

The rate of conjoined twins is 1 in 50,000 births. These patients usually have a common pericardial sac (90%) and conjoined hearts (75%). In case of shared heart there is a communication by a vascular channel between both atria and ventricles. If there is not ventricular communication, surgical separation is possible. We describe such a case in whom in spite that interventricular connections were present; surgical separation was decided because of the critical conditions of twin A in an effort to preserve the survival of twin B.

Gemelos unidos heterópagos. Presentación de cinco casos / Conjoined twins heteropagus. Presentation of five cases

Se describen cinco casos de gemelos unidos variedad heterópagos, de acuerdo a la clasificación de Potter. Contrario a la literatura, predominó el sexo masculino (3/5), la mortalidad fué de 40% (2/5). El primer caso presentó al parásito con extremidades y cráneo malformados, así como una porción del abdomen unidos al esternón y epigastrio. El segundo caso, el más raro de todos, incluso en la literatura internacional, mostraba una cabeza supernumeraria unida a la región occipito-parietal del autósito. Falleció por complicaciones no relacionadas a la cirugía. Los tres casos restantes presentaron al parásito unido a cara posterior del tórax, sacro o pelvis. Se presentan los resúmenes de los tres casos más representativos. En la actualidad, los tres pacientes sobrevivientes se encuentran en buenas condiciones. Se revisan las teorías sobre su embriogénesis y se analizan errores comunes de clasificación.