Through his usual humanitarian initiatives, Custodian of the Two Holy Mosques King Abdullah Bin Abdulaziz Al Saud has directed the separation of a set of Sudanese Siamese Conjoined twin girls to be performed at King Abdulaziz Medical City (KAMC) - Riyadh, after the completion of the necessary work-up.
In response to this directive, a specialized medical team headed by Dr. Abdullah Al Rabeeah, Consultant, Pediatric Surgeon (a known expert in this field) was formed immediately. The team included a number of physicians, surgeons, nursing staff and allied health personnel from the departments of Pediatrics and Pediatric Surgery, Pediatric Cardiology and Cardiac Surgery, Plastic Surgery, Anaesthesia, Pediatric Intensive Care, Medical Imaging, Operating Room, Nursing, Social Services, Rehabilitation, Public Affairs and Media Services.
The medical team planned a careful investigation, which included an ultrasound of the head, abdomen and pelvis, a CT scan and MRI of the chest and abdomen, and a hepatic veinogram. Also, a thorough work-up for the hearts of both twin was done.
These investigations have shown that each twin has a normal separate head, upper and lower limbs, pelvis and uro-genital system. However, both twin have fused livers and hearts with one twin having a small defect between the ventricles of her heart (VSD). Also, both twin have a shared peritoneum and possible fusion in the bowel.
After several meetings and careful review, the medical team agreed that separation is possible with salvage of both twin. The team decided to proceed with the separation on Monday, 21 January 2002 with a rehearsal of the procedure, which took place on Saturday, 19 January 2002.
It is noteworthy that the twin were born to a 35-year-old Sudanese mother on 27 September 2001, by Caesarian section. In her early pregnancy, there was a suspicion of twin pregnancy; however, only late in the pregnancy was it obvious that the mother was pregnant with triplets, of whom two were conjoined. This was diagnosed at the Maternity and Children's Hospital in Jeddah. The pregnancy lasted for 35 weeks.
The mother delivered three female babies by Caesarian section; one of them is normal and weighing 2100 g, whereas the remaining two were conjoined at their chest and abdomen and weighing 4000 g combined. The twin remained stable and after initial work-up, they were transferred to KAMC National Guard Hospital – Riyadh.