Siamese twins
| Classification according to ICD-10 | |
|---|---|
| Q89.4 | Siamese twins |
| ICD-10 online (WHO version 2019) | |
Siamese twins (also known as double malformations) denote an undesirable development in which identical twins remain physically connected to one another during their intrauterine development and after birth .
In identical (monozygous), monochorionic-monoamniotic twins, the fertilized egg cell divides into two independent embryonic structures. If the embryoblast is not completely lacerated in the late stage of development of the blastocyst after the 13th day after fertilization , the two fetuses remain connected.
The statistical probability of a double malformation is between 1: 60,000 and 1: 200,000. This corresponds to a frequency of 1: 300 in monozygous twin pregnancies . However, since an average of three out of ten Siamese twins die prenatally , only about one Siamese pair of twins per million live births. If it is known that a Siamese pair of twins is involved, the birth is usually carried out by caesarean section in order to keep the health risks for mother and children as low as possible.
The term is also used in a figurative sense for two different, possibly contradicting, but inseparably linked facts.
Expressions
The connection can reach as far as the internal organs or only affect external tissue . It can happen that a Siamese pair of twins only has one heart or one lungs .
In medicine, a distinction is made between the type and extent of adhesions. Adhesions can occur in different areas of the body:
- Chest area (thoracopagus, approx. 70% of cases)
- Hip area (sciatica, approx. 5% of cases)
- Head (craniopagus (cephalopagus), less than 2% of cases)
- Abdominal area (omphalopagus)
- Rump area (pygopagus)
- fetal inclusion or fetus in foeto with one twin being absorbed by the other intrauterine .
However, someone with, for example, two faces does not necessarily have to be a Siamese twin. It could also be cases of Diprosopus .
If separation is possible and necessary within the first three weeks after delivery, the average mortality is 50%, while between the fourth and 14th weeks the chance of survival is 90%. The (prenatal and postnatal) prognosis always depends on the type and extent of the fusion of the children.
Parasitic twin
The division does not always have to be symmetrical. If, for example, the cell material of a twin does not develop completely, asymmetrical (or parasitic ) double malformations can also occur. The more developed child, in this case also called autosity , carries the less developed child, the "parasite", on or in the body. In extreme cases, the less developed child can only consist of a tumor-like cluster of cells, which, however, must be differentiated from the teratoma (Greek teras , monster, freak '), a germ cell tumor that contains parts of all three germ layers.
separation
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Surgical separation of the two twins is possible, depending on the type and extent of the connection. A few requirements must be met:
- The two twins must each have all vital organs.
- The vital processes such as metabolism and respiration must not be intertwined in too complicated a manner (e.g. common blood vessels or several organs that are only present individually, such as the heart and liver).
By September 2004, 30 children who had grown together at the top of their skulls had survived separation, but 17 of them were disabled from the operation.
Famous cases
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- Descriptions of Siamese twins can be found at all times and places. B. Augustine von Hippo in De civitate Dei . Representations of Siamese twins are also known among the Moche in Peru .
- One of the first European traditions about Siamese twins is the legend of Mary and Eliza Chulkhurst from Biddenden , who were known as the Biddenden Maids and who are believed to have lived at the beginning of the 12th century.
- In Hartmann Schedel's Nuremberg Chronicle from 1493, several pairs are depicted.
- Michel de Montaigne wrote in his essay on a miscarriage of fourteen months: “But under the breast one saw it had grown together with another child, whose head was missing and whose vertebral canal had closed at the top; Otherwise he lacked nothing. One arm was shorter, but that was due to an accidental break during birth. "
- Lazarus and Joannes Baptista Colloredo traveled to numerous countries in the 17th century. Lazarus is said to have made a lot of money with his parasitic twin brother.
- The geographer Johann Gottfried Gregorii alias Melissantes describes in detail the profitable display of an eight-year-old Hungarian pair of sisters on the edge of the Leipzig Easter fair in 1709. The sisters Judith and Helena, who are overgrown in the rump area , were also presented to onlookers in Dresden and Vienna as an attraction for money.
- The name Siamese twins comes from the twin pair Chang and Eng Bunker (1811–1874) (in German the name is usually given as Bunkes instead of Bunker). The two brothers were born in Siam (today Thailand ), were known as the Siamese Twins as a fairground attraction and gave this malformation its name. The brothers married the sisters Adelaide and Sarah Yates and fathered a total of 18 children with them (21 children according to other sources). Both brothers died only hours in a row.
- Ritta and Christina Parodi, on the other hand, were not allowed to be exhibited in public, although there was great interest from the public and especially from medicine. The two little girls died in childhood.
- Giovanni Battista and Giacomo Tocci were born in 1877 and put on display at the age of four weeks. After they came of age, they withdrew behind the high walls of their estate in Italy so that they would never be exposed to prying eyes again.
- The sisters Daisy and Violet Hilton , born in 1908, were fused in their pelvis and back. Bought from their mother shortly after birth, they were exhibited at fairs like other Siamese twin pairs. As adults, they continued their show career on their own and starred in two films.
- The two 29-year-old sisters Ladan and Laleh Bijani from Iran (born January 17, 1974), who had grown together at the head and were separated from July 7, 2003 by a complex operation by a group of doctors in Singapore , also became famous . Shortly after the separation, Ladan Bijani died, a few hours later her sister Laleh too. According to the doctors, the cause of death was circulatory failure due to excessive blood loss during the operation.
- The sisters Abigail and Brittany Hensel (born March 7, 1990) received their own reality show . They share a common body, half of which they can control. Nevertheless, they have led a relatively normal life since they were born.
- In 2014 the Siamese twins Hope and Faith were born in Australia. The girls had separate brains and faces, but only one body. The twins were born by caesarean section six weeks before the expected date. At first it was not clear whether they would be able to breathe at all, but contrary to what was predicted, they were stable for a week after birth. Almost three weeks after their birth, hospital officials announced the death of the two girls on May 27, 2014.
Siamese twins in animals
A lack of separation of two identical twins also occurs in animals. Except in the case of pets, which are taken care of by the owner, this usually leads to the mother rejecting the twins in the case of mammals and thus to premature death.
The most common form is dicephaly, ie two heads that are completely duplicated from the neck or only in the face and brain with a common trunk and common extremities. While in the former such cases in humans (dicephalus dipus) two individuals are usually assumed, inconsistently in such cases in animals one speaks of an animal with two heads. Dicephaly is not only restricted to mammals, but has also been observed in amphibians and reptiles (e.g. snakes).
However, one must distinguish from dicephaly the malformation of Diprosopus , which can be traced back to other reasons . H. the two-faced with a single head, trunk and set of extremities. This malformation also occurs in humans (rarely documented) and animals. The pig Ditto has gained a certain fame in the USA over the past ten years , but it died as a result of simultaneous eating and breathing through the two existing mouth openings.
Siamese twins in the case of multiple births (in addition to twins)
Siamese multiples with more than two participants are also not excluded. However, since triplet births are already relatively rare, those with incomplete multiples are even rarer and accordingly hardly documented in the specialist literature.
Siamese twins in art
- Farrelly Brothers addressed the issue in 2003 in a comedy titled Stuck (Stuck on You) on.
- Siamese twins u. a. the basis of the psychological thriller The Inseparable .
- The mystery TV series The X-Files - The FBI's Scary Cases takes up the theme of the parasitic Siamese twin brotherhood in the episode The Circus (20th episode of the 2nd season).
- The Siamese twins appearing in the episode "Rose and Raven Rosenberg" of the series Nip / Tuck (season 2, episode 9) are represented by Reba and Lori Schappell. The two sisters strictly refuse to separate from each other.
- In the novel Job's Brothers , Rebecca Gablé describes the life of a Siamese pair of twins in the English High Middle Ages. The superstitious population takes them here alternately for good luck charms or godless monstrosities.
- In the US horror television series American Horror Story , Sarah Paulson portrays the Siamese twins Bette and Dot Tattler in season 4, who are attractions on a freak show in 1952 .
literature
- Juliet Butler: Masha & Dasha. Autobiography of a Siamese twin couple . Scherz, Bern [u. a.] 2000, ISBN 3-502-15097-4 ; also Droemer Knaur, Munich 2003, ISBN 3-426-77607-3 (Masha and Dasha Kriwoschljapowa (born January 3, 1950 in Moscow; † 2003) were fused at the waist. They had two upper bodies, but shared a lower body.)
- Angelika Friederici: Siamese twins in the Berlin Panoptika . In: Castan's Panopticum. A medium is viewed, issue 9, Schütze, Berlin 2010, ISBN 978-3-928589-23-9 .
- Stephanie Möller and Henning Röhl: Lea and Tabea. God willing. The moving story of the Siamese twins . Brunnen, Gießen (Basel) 2005, ISBN 3-7655-3867-1 .
- Lori Lansens: By my side . Ullstein, Berlin 2007, ISBN 978-3-548-26674-9 (autobiographical novel).
- Werner Böcker et al .: Pathology . 5th edition, Urban and Fischer / Elsevier, Munich 2012, ISBN 978-3-437-42384-0 .
- Radio broadcast on WDR 5 on January 17, 2014
Web links
- Siamese twins with only one kidney separated ( Der Spiegel )
- History, definition and separation of Siamese twins (Thieme)
- Mark Twain on Siamese Twins (English)
- Lakshmi, with video
Individual evidence
- Jump up ↑ Augustine of Hippo: Twenty-two books on the Divine State, 16th book, 8th chapter
- ↑ Michel de Montaigne Essais . First modern complete translation by Hans Stilett Die Other Bibliothek , Berlin 2016, 9th edition, 2nd book No. 30, pp. 352f
- ↑ Melissantes: The curieuse and learned HISTORICUS… Frankfurt, Leipzig [and Erfurt] 1712, pp. 515-521
- ↑ According to the US National Library of Medicine: From "Monsters" to Modern Medicine Miracles (accessed August 11, 2012): 21 children together, 11 of whom survived; Scheugl (1978) gives the number of 18 children.
- ↑ Die Welt: Siamese Twins with Two Faces and One Body Born , May 12, 2014. Retrieved May 15, 2014.
- ↑ DailyMail: The baby with two faces: Australian mother-of-seven gives birth to conjoined twin girls who share a body but have two brains , May 12, 2014. Retrieved May 15, 2014.
- ↑ Der Standard: Twins that had grown together died almost three weeks after birth , May 27, 2014. Accessed May 28, 2014.
