Rare Surgical Feat: Boy Freed from 15kg 'Parasitic Twin' After 17 Years

AIIMS physicians successfully carried out a procedure to disconnect a 'parasitic twin' weighing 15 kg from a 17-year-old boy who belonged to UP's Unnao district. Conjoined twins have a remarkable occurrence, and the frequency varies from 1 in 50,000 to 100,000 births. In some cases, incomplete growth causes asymmetrical or 'parasitic twins' in which one twin (autosite) completes development but the other (parasite) is still dependent. Such instances are very rare, with only 40 reported cases in global medical literature. Dr Asuri Krishna, an additional professor in the surgery department, said that when the boy came to AIIMS OPD on Jan 28, they first thought his wrapped abdomen was a carried child. Instead, they found two fully formed lower limbs with external genitalia on his abdomen.

From birth, the boy coexisted with a double set of limbs from his underdeveloped twin brother. The parasitic appendage and undeveloped male genitalia developed proportionately with him. The boy was sensitive to touch, pain and temperature of the parasitic limb. Without considerable abdominal pain, he preserved normal body functions free from significant complications of health.

His situation caused extensive social withdrawal and emotional struggles through childhood. Locals physicians counseled against extractions, warning of probable death due to mutual cardiac relationships. These situations prompted him to halt education at the age of 8 years. His physical limitation involved an inability to sleep on his abdomen.

The parasitic formation was getting nutrition via blood supply from the host twin. Doctors pointed out that with age, the like parasitic growths can lead to cardiovascular and neurological complications and even life-threatening ones. At the behest of a relative, he tried AIIMS as a last resort. He was assessed on arrival by a multidisciplinary team composed of surgeons, radiologists and anaesthesiologists.

AIIMS experts added that although prenatal screening is capable of identifying this condition, socio-economic status of the patient hindered early detection.CT angiography showed the blood supply to the parasitic limb came from an internal mammary artery branch. The scan also diagnosed a large abdominal cystic mass. After proper preparation, the surgery was planned on February 8, 2025.

The complicated operation was a two-step process: dissecting and ligating the parasitic limb out and then excising the abdominal cystic mass.Surgeons found and excised underdeveloped testes from the attachment site tissue. In the second phase, surgeons had to separately dissect the cystic mass from adjoining organs with care. They observed an unusually extended bladder, and this had to be carefully managed by surgery. Post-surgery drainage and suturing were done to finish the procedure. The procedure took 2 to 2.5 hours.

Physicians reported the patient to be free of any other health complications. Recovery was rapid, and successful oral feeding was resumed on the following day. The medical team removed the drain on the third day and cleared the patient for discharge home on the fourth day.

Physical and emotional 17 years of struggles came to an end after the successful operation. The patient initially suffered phantom sensations but could now look forward to a normal lifestyle.

The success was the outcome of joint efforts of several experts such as Dr Asuri Krishna, Dr VK Bansal, Dr Sushant Soren, Dr Brijesh Kumar Singh, Dr Abhinav Kumar, Dr Jaymeen Makwana from Surgical Specialties, Dr Manish Singhal and Dr Sashank from plastic surgery, Dr Ganga Prasad and Dr Rakesh from anaesthesia, and Dr Atin and Dr Ankita from radiology.