In a rare instance, two stillborn, male twins - both devoid of hearts as well - were successfully removed from inside their two-and-half-month-old living twin brother by surgeons at Banaras Hindu University (BHU) hospital on Monday.
Had the successful two-hour surgery not been performed by pediatric surgeons, the two undeveloped but parasite twins would have turned fatal to living twin Durgesh, on whose blood supply system were they surviving.
“The undeveloped twins sans any heart were surviving on the abdominal aorta of Durgesh (the largest artery in abdominal cavity). If the masterclass surgery, which could be a breakthrough in pediatric surgery was not performed successfully, the child’s life would have been in danger,” claimed Prof A N Gangopadhyay, Head of Pediatric Surgery Department at BHU Hospital, who headed the surgery.
Others in the team, included senior pediatric surgeon Dr S P Sharma, Pediatric Anaethesist Dr R B Singh, seniors residents Dr Punit, Dr Zahid and Dr Ram Avtar, besides two nursing staff -- Sister Sunita and Sister Neelam.
The two undeveloped parasite twins conjoined with each other through umbilical chord had developed brain, upper and lower limbs, spine, eyes and nose, besides external male genitalia, but had no heart and any mouth. Surviving on abdominal aorta of Durgesh, the two parasite male twins were attached to Durgesh’s body multiply, including via stomach, pancreas, duodenum and other parts, excepting kidney.
“We have dealt with surgical success four cases of foetus in foetu, all in female children four times in last 30 years at BHUI hospital, but never in past have we operated a male child with undeveloped feotus inside and that too twin foetuses (two male twins) inside. Its perhaps first in medical history that a case of ‘foetuses’ in foetu’ has been reported and that too where the host and parasite twins all are males,” Prof Gangopadhyay claimed.
After surgical removal of the congenital abnormality, Durgesh is fully fine now and will be discharged from hospital in a week, the surgeons added.
Firstborn of daily wager Hemant Bharti and Radhika Devi from Rampur Sohav village of neighbouring Ballia district, Durgesh was admitted at BHU hospital on Friday and after detailed tests, including CT Scan, 64 Slice CT Scan, X-ray and Ultrasound, the surgeons detected a foetus inside the foetu (an undeveloped twin inside Durgesh) and subsequently decided to save his life through the complex surgery on Monday.
The surgeons, however, were surprised to see and remove two and not one parasite male twin from Durgesh’s body on Monday. “Since the two twins were conjoined, tests only revealed a single tumour-like undeveloped twin inside earlier.”
Before being taken to a hospital in Buxar (Bihar) from where he was referred to BHU, Durgesh was vomitting routinely after being fed with mother’s milk and abnormal swelling was spotted near his stomach while he was being massaged.
Fetus in fetu (or foetus in foetu) is a developmental abnormality in which a foetus gets enveloped inside its twin and an entire living organ system with torso and limbs could develop inside the host. The abnormality occurs one in every one lakh live births and that too mostly in girls with the ratio of such abnormality in male to female child being 1:8. It occurs due to improper cell division of foetuses after fertilisation of male sperm and female eggs.