Published: 2020-05-22

Parasitic twin with major cardiac defect: a case report

Arindam Ghosh, Akshay Prasad, Tanusree Kundu, Priya Shalini Lakra, Kaushik Saha


Parasitic twins are an extremely rare form of asymmetrical conjoined monochorial monoamniotic twins where one of them has a mostly intact body that is able to survive and which is referred to as ‘autosite’, while the counterpart, referred to as ‘parasite’, is only rudimentarily developed being physically attached to and nourished by the other twin. Our case is a baby boy with Single Ventricle Heart defect with a thoraco-abdominal mass (epigastric heteropagus twin) attached to the anterior abdominal wall near the umbilicus with minimal visceral sharing. The twins had two external genitalia both in host and parasite micturating separately. After high risk surgery the parasite could be separated completely from the host and postoperative recovery was uneventful.


Double genitalia, Epigastric heteropagus, Parasitic Twin, Single Ventricle defect

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Dejene B, Negash SA, Mammo TN, Tadesse A, Getachew H, Derbew M. Heteropagus (parasitic) twins. J Pediatr Surg Case Rep. 2018 Oct 1;37:44-9.

Sharma G, Mobin SS, Lypka M, Urata M. Heteropagus (parasitic) twins: a review. J Pediatr Surg. 2010 Dec 1;45(12):2454-63.

Coran AG. Pediatric surgery. In: Pediatric surgery. seventh ed. Elsevier Saunders; 2012;7(131):1737- 1738.

Satter E, Tomita S. A case report of an omphalopagus heteropagus (parasitic) twin. J Pediatr Surg. 2008 Jun 1;43(6):e37-9.

Potter EL, Craig JM, Editors. Pathology of Fetus and New-born. 3rd ed. Chicago:Year Book;1975: 220-237.

Gupta DK, Lall A, Bajpai M. Epigastric heteropagus twins-a report of four cases. Pediatr Surg Int. 2001 Jul 1;17(5-6):481-2.

Qasim M, Shaukat M. Epigastric heteropagus twin. APSP J Case Rep. 2011 Sep;2(3):24.

Logroño R, Garcia‐Lithgow C, Harris C, Kent M, Meisner L. Heteropagus conjoined twins due to fusion of two embryos: report and review. Am J Medi Genet. 1997 Dec 19;73(3):239-43.

Abubakar AM, Ahidjo A, Chinda JY, Tahir C, Abubakar S, Adamu SA, Pindiga UH. The epigastric heteropagus conjoined twins. J Pediatr Surg. 2011 Feb 1;46(2):417-20.

Fierling R, Däster C, Arlettaz R. Heteropagus twins: report of two cases. Cases Month (COTMs). 2015 Jun.

Xie JT, Zhou L, Yang ZL, Sun HY. Epigastric heteropagus conjoined twins: two case studies and associated DNA analysis. Clinics. 2012;67(5):527-9.

Harris I, Lui G. Single Ventricle Defects and the Fontan; Adult Congenital Heart Association (ACHA): 888-921-ACHA (2242) Available at:

Hager J, Sanal M, Trawöger R, Gassner I, Oswald E, Rudisch A, Schaefer G, Mikuz G, Sergi C. Conjoined epigastric heteropagus twins: excision of a parasitic twin from the anterior abdominal wall of her sibling. Eur J Pediatr Surg. 2007 Feb;17(01):66-71.