A case of thoraco-omphalopagus conjoined twins with intrauterine death

Conjoined twins or Siamese twins are identical twins that are joined in utero. The original Siamese twins were born in Siam (now Thailand) in 1811. They were males and lived for about 62 years. Incidence being 1 in 49,000 births to 1 in 1,89,000 births, this phenomenon is very rare. Approximate half are stillborn and one- third die within 24 hours of birth. Five types of conjoint twins are classically described, thoracopagus, omphalopagus, pygopagus, ischiopagus and craniopagus. With a reported incidence of 74-75% of all conjoint twins, Thoracopagus is the most common type. Omphalopagus with an incidence of 0.5% is the least common. Here we are reporting a case of thoraco-omphalopagus twin pregnancy with intra uterine death delivered by hysterotomy.

Introduction

The introduction begins with the retrospective observation of the writer Elizabeth Ellet that Washington society once referred to James Buchanan and William Rufus King as the “Siamese twins.” From there, the book presents the modern, often sexualized understandings of their relationship and briefly surveys what the existing literature on politics, sexuality, and friendship offers this book, including the arguments of Buchanan biographer Philip Klein and novelist John Updike. The book argues that their personal and political relationship conformed to a model of intimate male friendship, or “bosom friendship,” prevalent in nineteenth-century America. It then outlines the chapters that compose the book and concludes by calling for greater attention to the part played by historical memory in the study of these two much misinterpreted figures.