Conjoined twins
Overview
Conjoined twins are identical twins whose bodies are joined in utero. A rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 100,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...

, and a smaller fraction of pairs born alive have abnormalities incompatible with life. The overall survival rate for conjoined twins is approximately 25%.
Encyclopedia
Conjoined twins are identical twins whose bodies are joined in utero. A rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 100,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn
Stillbirth
A stillbirth occurs when a fetus has died in the uterus. The Australian definition specifies that fetal death is termed a stillbirth after 20 weeks gestation or the fetus weighs more than . Once the fetus has died the mother still has contractions and remains undelivered. The term is often used in...

, and a smaller fraction of pairs born alive have abnormalities incompatible with life. The overall survival rate for conjoined twins is approximately 25%. The condition is more frequently found among females, with a ratio of 3:1.

Two contradicting theories exist to explain the origins of conjoined twins. The older theory is fission, in which the fertilized egg splits partially. The second and more generally accepted theory is fusion, in which a fertilized egg completely separates, but stem cell
Stem cell
This article is about the cell type. For the medical therapy, see Stem Cell TreatmentsStem cells are biological cells found in all multicellular organisms, that can divide and differentiate into diverse specialized cell types and can self-renew to produce more stem cells...

s (which search for similar cells) find like-stem cells on the other twin and fuse the twins together. Conjoined twins share a single common chorion, placenta, and amniotic sac, although these characteristics are not exclusive to conjoined twins as there are some monozygotic but non-conjoined twins that also share these structures in utero.

The most famous pair of conjoined twins was Chang and Eng Bunker
Chang and Eng Bunker
Chang and Eng Bunker were the conjoined twin brothers whose condition and birthplace became the basis for the term "Siamese twins".-Life:...

 (Thai: อิน-จัน, In-Chan) (1811–1874), Thai
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...

 brothers born in Siam, now Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...

. They traveled with P.T. Barnum's circus for many years and were billed as the Siamese Twins. Chang and Eng were joined by a band of flesh, cartilage, and their fused livers at the torso. In modern times, they could have been easily separated. Due to the brothers' fame and the rarity of the condition, the term "Siamese twins" came to be used as a synonym
Synonym
Synonyms are different words with almost identical or similar meanings. Words that are synonyms are said to be synonymous, and the state of being a synonym is called synonymy. The word comes from Ancient Greek syn and onoma . The words car and automobile are synonyms...

 for conjoined twins.

Types of conjoined twins

Conjoined twins are typically classified by the point at which their bodies are joined. The most common types of conjoined twins are:
  • Thoraco-omphalopagus (32% of cases): Two bodies fused from the upper chest to the lower chest. These twins usually share a heart, and may also share the liver
    Liver
    The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

     or part of the digestive system.
  • Thoracopagus (40%): Two bodies fused from the upper thorax
    Thorax
    The thorax is a division of an animal's body that lies between the head and the abdomen.-In tetrapods:...

     to lower belly. The heart
    Heart
    The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

     is always involved in these cases.
  • Omphalopagus (33%): Two bodies fused at the lower chest
    Chest
    The chest is a part of the anatomy of humans and various other animals. It is sometimes referred to as the thorax or the bosom.-Chest anatomy - Humans and other hominids:...

    . Unlike thoracopagus, the heart is never involved in these cases; however, the twins often share a liver
    Liver
    The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

    , digestive system, diaphragm and other organs.
  • Parasitic twins (7%): Twins that are asymmetrically conjoined, resulting in one twin that is small, less formed, and dependent on the larger twin for survival.
  • Craniopagus (2%): Fused skull
    Human skull
    The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...

    s, but separate bodies. These twins can be conjoined at the back of the head, the front of the head, or the side of the head, but not on the face or the base of the skull.


Other less-common types of conjoined twins include:
  • Cephalopagus: Two faces on opposite sides of a single, conjoined head; the upper portion of the body is fused while the bottom portions are separate. These twins generally cannot survive due to severe malformations of the brain. Also known as janiceps (after the two-faced god Janus
    Janus (mythology)
    In ancient Roman religion and mythology, Janus is the god of beginnings and transitions, thence also of gates, doors, doorways, endings and time. He is usually a two-faced god since he looks to the future and the past...

    ) or syncephalus.
  • Synecephalus: One head with a single face but four ears, and two bodies.
  • Cephalothoracopagus: Bodies fused in the head and thorax. In this type of twins, there are two faces facing in opposite directions, or sometimes a single face and an enlarged skull.
  • Xiphopagus: Two bodies fused in the xiphoid cartilage, which is approximately from the navel to the lower breastbone. These twins almost never share any vital organs, with the exception of the liver. A famous example is Chang and Eng Bunker.
  • Ischiopagus
    Ischiopagi
    Ischiopagi is the medical term used for conjoined twins united at the pelvis.It specifically describes a condition involving the fused lower half of the two bodies, with spines conjoined end-to-end at a 180° angle...

    : Fused lower half of the two bodies, with spines
    Vertebral column
    In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...

     conjoined end-to-end at a 180° angle. These twins have four arms; two, three or four legs; and typically one external set of genitalia and anus
    Anus
    The anus is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, unwanted semi-solid matter produced during digestion, which, depending on the type of animal, may be one or more of: matter which the animal cannot digest,...

    .
  • Omphalo-Ischiopagus: Fused in a similar fashion as ischiopagus twins, but facing each other with a joined abdomen akin to omphalopagus. These twins have four arms, and two, three, or four legs.
  • Parapagus: Fused side-by-side with a shared pelvis. Twins that are dithoracic parapagus are fused at the abdomen and pelvis, but not the thorax. Twins that are diprosopic parapagus have one trunk and one head with two faces. Twins that are dicephalic parapagus have one trunk and two heads
    Polycephaly
    Polycephaly is a condition of having more than one head. The term is derived from the Greek stems poly- meaning 'much' and kephali- meaning "head", and encompasses bicephaly and dicephaly . A variation is an animal born with two faces on a single head, a condition known as diprosopus...

    , and two (dibrachius), three (tribrachius), or four (tetrabrachius) arms.
  • Craniopagus parasiticus
    Craniopagus parasiticus
    Craniopagus parasiticus is a medical condition in which a parasitic twin head with an undeveloped body is attached to the head of a developed twin.-Cases:...

    : Like craniopagus, but with a second bodiless head attached to the dominant head.
  • Pygopagus (Iliopagus): Two bodies joined at the pelvis.

Separation

Surgery to separate conjoined twins may range from relatively simple to extremely complex, depending on the point of attachment and the internal parts that are shared. Most cases of separation are extremely risky and life-threatening. In many cases, the surgery results in the death of one or both of the twins, particularly if they are joined at the head. This makes the ethics
Ethics
Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...

 of surgical separation, where the twins can survive if not separated, contentious. Dreger found the quality of life of twins who remain conjoined to be higher than is commonly supposed. Lori and George Schappell are a good example.

Recent successful separations of conjoined twins include that of the separation of Ganga & Jamuna Shreshta in 2001, who were born in Kathmandu, Nepal in 2000. The 97 hour surgery on the pair of craniopagus twins
Craniopagus twins
Craniopagus twins are conjoined twins who are conjoined at the cranium. This condition occurs in conjoined twin in about 1 in every 2,500,000 births...

 was a landmark one which took place in Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

; the team was led by neurosurgeons, Dr. Chumpon Chan and Dr. Keith Goh.
Ganga Shrestha died at the Model Hospital in Katmandu in July 2009, at the age of 8, three days after being admitted for treatment of a severe chest infection.

In 2003 two women from Iran, Ladan and Laleh Bijani
Ladan and Laleh Bijani
Ladan Bijani and Laleh Bijani were Iranian law graduates. They were conjoined twin sisters, joined at the head, who died after their complicated surgical separation...

, who were joined at the head but had separate brains (craniopagus) were surgically separated in Singapore, despite surgeons' warnings that the operation could be fatal to one or both. Both women died during surgery on July 8, 2003.

A case of particular interest was that of Rosie and Gracie Attard, two conjoined twins from Malta who were separated by court order in Great Britain over the religious objections of their parents, Michaelangelo and Rina Attard. The surgery took place in November, 2000, at St Mary's Hospital
St Mary's Hospital, Manchester
St Mary's Hospital is a hospital in Manchester, England. It is part of Central Manchester University Hospitals NHS Foundation Trust. It was founded in 1790. St Mary's provides a unique range of inter-related services specifically for women and children...

 in Manchester
Manchester
Manchester is a city and metropolitan borough in Greater Manchester, England. According to the Office for National Statistics, the 2010 mid-year population estimate for Manchester was 498,800. Manchester lies within one of the UK's largest metropolitan areas, the metropolitan county of Greater...

. The operation was controversial because Rosie, the weaker twin, would die as a result of the procedure as her heart and lungs were dependent upon Gracie's. (The twins were attached at the lower abdomen and spine.) However, if the operation had not taken place, it was certain that both twins would die.

Conjoined twins in history

The Moche
Moche
'The Moche civilization flourished in northern Peru from about 100 AD to 800 AD, during the Regional Development Epoch. While this issue is the subject of some debate, many scholars contend that the Moche were not politically organized as a monolithic empire or state...

 culture of ancient Peru
Peru
Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean....

 depicted conjoined twins in their ceramics dating back to 300 CE. The earliest known documented case of conjoined twins dates from the year 942, when a pair of conjoined twin brothers from Armenia
Armenia
Armenia , officially the Republic of Armenia , is a landlocked mountainous country in the Caucasus region of Eurasia...

 were brought to Constantinople
Constantinople
Constantinople was the capital of the Roman, Eastern Roman, Byzantine, Latin, and Ottoman Empires. Throughout most of the Middle Ages, Constantinople was Europe's largest and wealthiest city.-Names:...

 for medical evaluation.

In Arabia, the twin brothers Hashim ibn Abd Manaf
Hashim ibn Abd Manaf
Hashim ibn 'Abd Manaf was the great-grandfather of the Islamic prophet Muhammad and the progenitor of the Banu Hashim clan of the distinguished Quraish tribe in Mecca....

 and 'Abd Shams were born with Hashim's leg attached to his twin brother's head. Legend says that their father, Abd Manaf ibn Qusai
Abd Manaf ibn Qusai
‘Abdu Manāf ibn Quṣayy was a Quraishi and great-great-grandfather of the Islamic prophet Muhammad and Ali. His father was Quṣayy ibn Kilāb.-Biography:...

, separated his conjoined sons with a sword and that some priests believed that the blood that had flown between them signified wars between their progeny (confrontations did occur between Banu al'Abbas and Banu Ummaya ibn 'Abd Shams in the year 750 AH). The Muslim
Muslim
A Muslim, also spelled Moslem, is an adherent of Islam, a monotheistic, Abrahamic religion based on the Quran, which Muslims consider the verbatim word of God as revealed to prophet Muhammad. "Muslim" is the Arabic term for "submitter" .Muslims believe that God is one and incomparable...

 polymath
Polymath
A polymath is a person whose expertise spans a significant number of different subject areas. In less formal terms, a polymath may simply be someone who is very knowledgeable...

 Abū al-Rayhān al-Bīrūnī described Siamese twins in his book Kitab-al-Saidana.

The English twin sisters Mary and Eliza Chulkhurst
Mary and Eliza Chulkhurst
Mary and Eliza Chulkhurst , commonly known as the Biddenden Maids, were a pair of conjoined twins supposedly born in Biddenden, Kent, in the year 1100. They are said to have been joined at both the shoulder and the hip, and to have lived for 34 years...

, who were conjoined at the back (pygopagus), lived from 1100 to 1134 (or 1500 to 1534) and were perhaps the best-known early historical example of conjoined twins. Other early conjoined twins to attain notice were the "Scottish brothers", allegedly of the dicephalus type, essentially two heads sharing the same body (1460–1488, although the dates vary); the pygopagus Helen and Judith of Szőny, Hungary (1701–1723), who enjoyed a brief career in music before being sent to live in a convent
Convent
A convent is either a community of priests, religious brothers, religious sisters, or nuns, or the building used by the community, particularly in the Roman Catholic Church and in the Anglican Communion...

; and Rita and Cristina of Parodi of Sardinia
Sardinia
Sardinia is the second-largest island in the Mediterranean Sea . It is an autonomous region of Italy, and the nearest land masses are the French island of Corsica, the Italian Peninsula, Sicily, Tunisia and the Spanish Balearic Islands.The name Sardinia is from the pre-Roman noun *sard[],...

, born in 1829. Rita and Cristina were dicephalus tetrabrachius (one body with four arms) twins and although they died at only eight months of age, they gained much attention as a curiosity when their parents exhibited them in Paris.

Several sets of conjoined twins lived during the nineteenth century and made careers for themselves in the performing arts
Performing arts
The performing arts are those forms art which differ from the plastic arts insofar as the former uses the artist's own body, face, and presence as a medium, and the latter uses materials such as clay, metal or paint which can be molded or transformed to create some physical art object...

, though none achieved quite the same level of fame and fortune as Chang and Eng. Most notably, Millie and Christine McCoy
Millie and Christine McCoy
Millie McCoy and Christine McCoy were American conjoined twins who went by the stage names "The Two-Headed Nightingale" and "The Eighth Wonder of the World"....

 (or McKoy), pygopagus twins, were born into slavery in North Carolina in 1851. They were sold to a showman
Showman
Showman can have a variety of meanings, usually by context and depending on the country.- Australia :Travelling showmen are people who run amusement and side show equipment at regional shows, state capital shows, events and festivals throughout Australia...

, J.P. Smith, at birth, but were soon kidnapped by a rival showman. The kidnapper fled to England but was thwarted because England had already banned slavery. Smith traveled to England to collect the girls and brought with him their mother, Monimia, from whom they had been separated. He and his wife provided the twins with an education and taught them to speak five languages, play music, and sing. For the rest of the century the twins enjoyed a successful career as "The Two-Headed Nightingale" and appeared with the Barnum Circus. In 1912 they died of tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

, 17 hours apart.

Giovanni and Giacomo Tocci, from Locana
Locana
Locana is a comune in the Province of Turin in the Italian region Piedmont, located about 45 km northwest of Turin in the Orco Valley...

, Italy, were immortalized in Mark Twain
Mark Twain
Samuel Langhorne Clemens , better known by his pen name Mark Twain, was an American author and humorist...

's short story "Those Extraordinary Twins" as fictitious twins Angelo and Luigi. The Toccis, born in 1877, were dicephalus tetrabrachius twins, having one body with two legs, two heads, and four arms. From birth they were forced by their parents to perform and never learned to walk, as each twin controlled one leg (in modern times physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

 allows twins like the Toccis to learn to walk on their own). They are said to have disliked show business. In 1886, after touring the United States, the twins returned to Europe with their family, where they fell very ill. They are believed to have died around this time, though some sources claim they survived until 1940, living in seclusion in Italy.

Born 19th century and earlier

  • Mary and Eliza Chulkhurst
    Mary and Eliza Chulkhurst
    Mary and Eliza Chulkhurst , commonly known as the Biddenden Maids, were a pair of conjoined twins supposedly born in Biddenden, Kent, in the year 1100. They are said to have been joined at both the shoulder and the hip, and to have lived for 34 years...

     (1100–1134) (or 1500–1534, also known as the Biddenden Maids) from England. They are the earliest set of conjoined twins whose names are known.
  • Lazarus and Joannes Baptista Colloredo
    Lazarus and Joannes Baptista Colloredo
    Lazarus Colloredo and Joannes Baptista Colloredo were Italian conjoined twins who toured in 17th century Europe. They were born in Genoa, Italy....

     (1617-164?)
  • Helen and Judith of Szony
    Helen and Judith of Szony
    Helen and Judith, also known as the Hungarian Sisters, were conjoined twins from Szőny, Hungary who lived from October 19, 1701 – February 8, 1723. In the image they appear to be pygopagus....

     (Hungary, 1701–1723)
  • Chang and Eng Bunker
    Chang and Eng Bunker
    Chang and Eng Bunker were the conjoined twin brothers whose condition and birthplace became the basis for the term "Siamese twins".-Life:...

     (1811–1874), from Thailand
    Thailand
    Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...

     (formerly Siam), joined by the areas around their xiphoid cartilage
    Xiphoid process
    The xiphoid process, or xiphisternum or metasternum, is a small cartilaginous process of the lower part of the sternum which is usually ossified in the adult human. By age 15 to 29, the xiphoid usually fuses to the body of the sternum with a fibrous joint. Unlike the synovial articulation of major...

    s, but over time the join stretched; the expression Siamese twins is derived from their case
  • Millie and Christine McCoy
    Millie and Christine McCoy
    Millie McCoy and Christine McCoy were American conjoined twins who went by the stage names "The Two-Headed Nightingale" and "The Eighth Wonder of the World"....

     (July 11, 1851 - October 8, 1912) were American conjoined twins who went by the stage names "The Two-Headed Nightingale" and "The Eighth Wonder of the World".
  • Giacomo and Giovanni Battista Tocci
    Giacomo and Giovanni Battista Tocci
    Giacomo and Giovanni Battista Tocci were Dicephalic conjoined twins born in Locana, Italy between 1875 and 1877 on either July 4 or October 4.- Birth :...

     (1875?-1912?)
  • Rosa and Josepha Blazek of Bohemia
    Bohemia
    Bohemia is a historical region in central Europe, occupying the western two-thirds of the traditional Czech Lands. It is located in the contemporary Czech Republic with its capital in Prague...

     (modern-day Czech Republic (1878–1922)). Rosalie gave birth in 1910 to a son, in the only recorded instance of a conjoined twin becoming pregnant and carrying a child to term.
  • Radica and Doodica were born in Orissa, India in 1888. They were xiphopagus twins, joined at the chest by a band of cartilage, similar to Chang and Eng. The sisters were separated in Paris by Dr. Eugène-Louis Doyen
    Eugène-Louis Doyen
    Eugène-Louis Doyen was a French surgeon who was a native of Reims. He was the son of Octave Doyen , who served as mayor of Reims....

     with the hope of saving Radica. Dr. Doyen was a pioneering medical filmmaker and filmed the twins' surgery as La Separation de Doodica-Radica. Though the operation was considered a success at first, Doodica died shortly after separation, and Radica also succumbed to tuberculosis in 1903, having lived the last year of her life in a Paris sanitorium.

Born 20th century

  • Tamonotanye and Waiboko, known as Boko and Tomo (July 25, 1953). Born in Kano
    Kano
    Kano is a city in Nigeria and the capital of Kano State in Northern Nigeria. Its metropolitan population is the second largest in Nigeria after Lagos. The Kano Urban area covers 137 sq.km and comprises six Local Government Area - Kano Municipal, Fagge, Dala, Gwale, Tarauni and Nassarawa - with a...

    , Nigeria
    Nigeria
    Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...

     to Bantu shop assistant Veronica Davies, joined at the abdomen. Taken to London and surgically separated at Hammersmith Hospital
    Hammersmith Hospital
    Hammersmith Hospital is a major teaching hospital in West London. It is part of Imperial College Healthcare NHS Trust in the London Borough of Hammersmith and Fulham, and is associated with the Imperial College Faculty of Medicine...

     in December, 1953 by Ian Aird, Professor of Surgery at the Royal Post-graduate school of Medicine, London. Tomo died in surgery, but Boko returned to Nigeria.
  • Ganga and Jamuna Mondal (1969/1970-), the "spider girls" of Basirhat
    Basirhat
    Basirhat is a city and a municipality in North 24 Parganas district in the state of West Bengal, India. Basirhat subdivisional town is located on the banks of Ichamati River.- History :...

    , West Bengal
    West Bengal
    West Bengal is a state in the eastern region of India and is the nation's fourth-most populous. It is also the seventh-most populous sub-national entity in the world, with over 91 million inhabitants. A major agricultural producer, West Bengal is the sixth-largest contributor to India's GDP...

    , India http://www.phreeque.com/jandal_sisters.html.
  • Daisy and Violet Hilton
    Daisy and Violet Hilton
    Daisy Hilton and Violet Hilton were a pair of conjoined twins who toured in the U.S. sideshow and vaudeville circuit in the 1930s.-Early life:...

     of Brighton, East Sussex, England (1908–1969), born in England, lived in United States, actresses, appeared in the movies Freaks
    Freaks
    Freaks is a 1932 American Pre-Code horror film about sideshow performers, directed and produced by Tod Browning and released by Metro-Goldwyn-Mayer, with a cast mostly composed of actual carnival performers. The film was based on Tod Robbins' 1923 short story "Spurs"...

    and Chained for Life
    Chained for Life
    Chained for Life is a 1951 exploitation film featuring the famous conjoined Hilton Twins, Daisy and Violet. It features several vaudeville acts, including juggler Whitey Roberts, a man doing bicycle stunts, and a man who plays the William Tell Overture at breakneck speed on an accordion.The movie...

  • Lucio and Simplicio Godina
    Lucio and Simplicio Godina
    Lucio Godina and Simplicio Godina were pygopagus conjoined twins from the island of Samar in the Philippines....

    of Samar, Philippines
    Philippines
    The Philippines , officially known as the Republic of the Philippines , is a country in Southeast Asia in the western Pacific Ocean. To its north across the Luzon Strait lies Taiwan. West across the South China Sea sits Vietnam...

     (1908–1936)
  • Mary and Margaret Gibb of Holyoke, Massachusetts
    Massachusetts
    The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...

     (1912–1967)
  • Juraci and Nadi Climerio de Oliverras (1957–1974)
  • Yvonne and Yvette McCarther of Los Angeles, California
    California
    California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...

     (1949–1992)
  • Masha and Dasha Krivoshlyapova
    Masha and Dasha Krivoshlyapova
    Masha and Dasha Krivoshlyapova were Russian conjoined twins of the Ischiopagus tripus variety...

     (ischiopagus tripus) Moscow, Russia (1950–2003), Soviet/Russian twin girls, rarest form of conjoined twins, only known case of dicephalus tetrabrachius tripus (two heads, four arms, three legs). The third, fused leg was amputated when the twins were 16 or 17.
  • Lotti and Rosemarie Knaack (craniopagus) born in Hamburg
    Hamburg
    -History:The first historic name for the city was, according to Claudius Ptolemy's reports, Treva.But the city takes its modern name, Hamburg, from the first permanent building on the site, a castle whose construction was ordered by the Emperor Charlemagne in AD 808...

    , Germany in 1951. Separated in 1957 when they were nearly six years old. Lotti died in surgery.
  • Ronnie and Donnie Galyon
    Ronnie and Donnie Galyon
    Ronnie and Donnie Gaylon are two American conjoined twins, who hold the current record for the oldest conjoined twins....

     of Ohio
    Ohio
    Ohio is a Midwestern state in the United States. The 34th largest state by area in the U.S.,it is the 7th‑most populous with over 11.5 million residents, containing several major American cities and seven metropolitan areas with populations of 500,000 or more.The state's capital is Columbus...

     (1951–), currently the world's oldest living conjoined twins, Omphalopagus
  • Lori and George (formerly Reba, born Dori) Schappell born September 18, 1961 in Reading, Pennsylvania
    Reading, Pennsylvania
    Reading is a city in southeastern Pennsylvania, USA, and seat of Berks County. Reading is the principal city of the Greater Reading Area and had a population of 88,082 as of the 2010 census, making it the fifth most populated city in the state after Philadelphia, Pittsburgh, Allentown and Erie,...

    , American entertainers, craniopagus.
  • Sherrie and Sharise Jones born on June 15, 1967 and successfully separated on November 13, 1968 in Brooklyn, New York, ischiopagus tripus conjoined twins
  • Ladan and Laleh Bijani
    Ladan and Laleh Bijani
    Ladan Bijani and Laleh Bijani were Iranian law graduates. They were conjoined twin sisters, joined at the head, who died after their complicated surgical separation...

    of Shiraz
    Shiraz
    Shiraz may refer to:* Shiraz, Iran, a city in Iran* Shiraz County, an administrative subdivision of Iran* Vosketap, Armenia, formerly called ShirazPeople:* Hovhannes Shiraz, Armenian poet* Ara Shiraz, Armenian sculptor...

    , Iran (Persia) (1974–2003); died during separation surgery in Singapore
  • Viet and Duc Nguyen
    Viet and Duc Nguyen
    Viet Nguyen and Duc Nguyen were a pair of conjoined twins born in Vietnam and surgically separated in 1988. Viet died in 2007 of natural causes.-Biography:...

    , born on February 25, 1981 in Kon Tum Province
    Kon Tum Province
    Kon Tum province lies in the Central Highlands region of Vietnam and shares borders with Laos and Cambodia. It has an area of 9,934 square km and a population of approximately 330,000. The economy is primarily agricultural.-Name:...

    , Tây Nguyên
    Tây Nguyên
    Tây Nguyên, translated as Western Highlands and sometimes also called Central Highlands, is one of the regions of Vietnam. It contains the provinces of Đắk Lắk, Đắk Nông, Gia Lai, Kon Tum, Lâm Đồng....

    , Vietnam
    Vietnam
    Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...

    , and separated on October 4, 1988 in Ho Chi Minh City
    Ho Chi Minh City
    Ho Chi Minh City , formerly named Saigon is the largest city in Vietnam...

    . Viet died on October 6, 2007.
  • Matt and Mark Hildebrandt, born April 17, 1973, England, Craniopagus, separated age 2, Matt died 2008.
  • Ruthie and Verena Cady, born April 13, 1984, thoracopagus twins. Died of heart and respiratory problems July 19, 1991.
  • Hassan and Hussein Salih, born August 21, 1986, (Omdurman, Sudan/London, England (UK) - Separated April 1987 at Great Ormand Street Children's Hospital - Survived.
  • Katie and Eilish Holton of Kildare, Ireland, babies born joined at the shoulder in 1988. They were born with separate heads and necks but their bodies were joined from the shoulders down. Katie died a few days after separation in 1992.
  • Abigail and Brittany Hensel
    Abigail and Brittany Hensel
    Abigail "Abby" Loraine Hensel and Brittany "Britty" Lee Hensel are dicephalic parapagus twins, meaning that they are conjoined twins of whom each has a separate head, but whose bodies are joined. They are highly symmetric, giving the appearance of having just a single body with little variation...

    , born March 7, 1990 in Carver County, Minnesota
    Minnesota
    Minnesota is a U.S. state located in the Midwestern United States. The twelfth largest state of the U.S., it is the twenty-first most populous, with 5.3 million residents. Minnesota was carved out of the eastern half of the Minnesota Territory and admitted to the Union as the thirty-second state...

    , United States of America, dicephalic conjoined twins, two heads, two arms, two legs, cannot be separated
  • Iesha and Teisha Turner, born April 19, 1991 Successfully separated at Texas Children's Hospital
    Texas Children's Hospital
    Texas Children's Hospital is a pediatric hospital located in the Texas Medical Center in Houston, Texas.With 639 licensed beds and 465 beds in operation, Texas Children's is the largest children's hospital in the United States and is affiliated with the Baylor College of Medicine as that...

  • Gita and Zita Rezekhanova, born October 19, 1991 Successfully separated in Moscow, Russia
  • Ram and Laxman 1992 Successfully separated at Guntur
    Guntur
    Guntur , is a city and a municipal corporation in the Indian state of Andhra Pradesh, located to the north and west of the Bay of Bengal. It is approximately to the south of the national capital, New Delhi and south east of state capital, Hyderabad. Guntur is the fourth largest city in Andhra...

    , India
  • Stefan and Tyler Delp, born 1992 in Philadelphia, United States of America.
  • José Patricio and Marcelo Antonio Fuentes, born in Chile
    Chile
    Chile ,officially the Republic of Chile , is a country in South America occupying a long, narrow coastal strip between the Andes mountains to the east and the Pacific Ocean to the west. It borders Peru to the north, Bolivia to the northeast, Argentina to the east, and the Drake Passage in the far...

     on October 2, 1992, they were joined from their abdomen, with their hearts united and sharing their liver. Were successfully separated on June 29, 1993 on a surgery that lasted for ten hours, however, Marcelo Antonio suffered an infection when he was eight years old, which caused his death on November 24, 2000.
  • Anjali and Geetanjali 1993 Successfully separated at Guntur, India
  • Rekha and Surekha 1998 Successfully separated at Guntur, India
  • Shawna and Janelle Roderick (thoracopagus) separated May 31, 1996 at Loma Linda Children's Hospital
    Loma Linda University Medical Center
    Loma Linda University Medical Center is a teaching hospital on the campus of Loma Linda University in Loma Linda, California, United States. The medical center serves as a level I trauma center for San Bernardino County and the rest of the Inland Empire. It is one of two closest trauma centers for...

    .

Born 21st century

  • Carmen and Lupita Andrade-Solis, born in Mexico
    Mexico
    The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...

     2000 with Dicephalus Tetrabrachius Dipus (2 heads, 4 arms and 2 legs). Separation was not possible.
  • Ganga and Jamuna Shreshta of Nepal
    Nepal
    Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...

    , conjoined twins born May 9, 2000 who were separated in a landmark surgery in Singapore
    Singapore
    Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

     in 2001, by a team led by Dr. Chumpon Chan; Ganga died on July 29, 2008 at the age of 8 of a chest infection;
  • Rose and Grace Attard ("Mary and Jodie"), Maltese twins joined at spine, born October 2000. Separated in Great Britain by court order against the wishes of their parents, because Mary could not survive independently. Mary died upon separation.
  • Ayşe and Sema Tanrikulu born in Kahramanmaraş
    Kahramanmaras
    -Industry:Kahramanmaraş's industry is mainly based on textile and ice cream. Kahramanmaraş is one of the biggest textile industry cities of Turkey. Companies like Kipaş, İskur, Arsan and Bozkurt are one of the richest companies in the city...

    , Turkey
    Turkey
    Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...

     on December 24, 2000 with Dicephalus Tetrabrachius Dipus (2 heads, 4 arms and 2 legs).
  • Lexi and Syd Stark Born in 2001, successfully separated later.
  • Mohamed and Ahmed Ibrahim, born in a small Egyptian town on June 2, 2001, separated in a 34-hour operation at Children's Medical Center Dallas on October 12, 2003
  • Carl and Clarence Aguirre
    Carl and Clarence Aguirre
    Clarence and Carl Aguirre are former conjoined twins born in Silay City, Philippines. They were conjoined at the top of the head . In 2003 they were brought to the United States by their mother Arlene in the hopes of having them surgically separated. A revolutionary new process was used in...

    , born vertical craniopagus in Manila on April 21, 2002 were successfully separated using a staged procedure performed over the course of 10 months at the Children's Hospital at Montefiore in New York City. The separation occurred on August 4, 2004.
  • Tamara and Isidora Ulloa, born in Chile
    Chile
    Chile ,officially the Republic of Chile , is a country in South America occupying a long, narrow coastal strip between the Andes mountains to the east and the Pacific Ocean to the west. It borders Peru to the north, Bolivia to the northeast, Argentina to the east, and the Drake Passage in the far...

     on August 7, 2002, were joined by the thorax and abdomen. Died on January 28, 2003 due to respiratory failure.
  • Kendra and Maliyah Herrin ischiopagus twins separated in 2006 at age 4. Born with only one kidney between the two, Maliyah received a kidney transplant from her mother in 2007. The twins' mother then wrote a book about her experiences titled "When Hearts Conjoin", the only book about conjoined twins written by a parent of conjoined twins.
  • Zoe and Ana (born in 2003) conjoined at the head and successfully separated in Rome in October 2003.
  • Daria and Olga Kolacz born in Lodz
    Lódz
    Łódź is the third-largest city in Poland. Located in the central part of the country, it had a population of 742,387 in December 2009. It is the capital of Łódź Voivodeship, and is approximately south-west of Warsaw...

    , Poland
    Poland
    Poland , officially the Republic of Poland , is a country in Central Europe bordered by Germany to the west; the Czech Republic and Slovakia to the south; Ukraine, Belarus and Lithuania to the east; and the Baltic Sea and Kaliningrad Oblast, a Russian exclave, to the north...

     on October 8, 2003, conjoined for 15 cm, sharing a common spine, part of the large intestines and anus (Pygopagus). The girls were successfully separated on January 3, 2005 in King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia.
  • Leah and Tabea Block born in 2003 in Lemgo/Germany, conjoined at the head, separated in Baltimore in 2004. Tabea died shortly afterward.
  • Macey and Mackenzie Garrison (born in 2003) in Indianola
    Indianola
    Indianola may refer to:*Indianola, California **Indianola , California**Indianola , California* Indianola, Florida* Indianola, Illinois* Indianola, Iowa* Indianola, Mississippi* Indianola, Nebraska...

    , Iowa
    Iowa
    Iowa is a state located in the Midwestern United States, an area often referred to as the "American Heartland". It derives its name from the Ioway people, one of the many American Indian tribes that occupied the state at the time of European exploration. Iowa was a part of the French colony of New...

    , United States.And separated on 2010.
  • Anastasia and Tatiana Dogaru
    Anastasia and Tatiana Dogaru
    Anastasia and Tatiana Dogaru are seven-year-old craniopagus conjoined twins. They were scheduled to begin the first of several surgeries to separate them at Rainbow Babies and Children's Medical Center in Cleveland, Ohio...

    , born outside Rome, Italy on January 13, 2004. As Craniopagus twins
    Craniopagus twins
    Craniopagus twins are conjoined twins who are conjoined at the cranium. This condition occurs in conjoined twin in about 1 in every 2,500,000 births...

    , the top of Tatiana's head is attached to the back of Anastasias's head. Although Anastasia is the bigger twin, she has no kidney function and relies entirely on Tatiana's kidneys. Due to the degree of their connection, they cannot be separated.
  • Sarah and Abbey (Pygopagus) born in New Zealand in 2004 and separated successfully later that year.
  • Veena and Vani 2004 Still to be operated
  • Lakshmi Tatma
    Lakshmi Tatma
    Lakshmi Tatama is an Indian girl born in 2005 in a village in Araria district, Bihar, having "4 arms and 4 legs." She was actually one of a pair of ischiopagus conjoined twins where one twin was headless due to its head atrophying and chest underdeveloping in the womb...

    (born 2005) was an ischiopagus conjoined twin born in Araria
    Araria
    Araria is a town and a municipality that is headquarters of Araria district in the state of Bihar, India.-Geography:Araria is located at . It has an average elevation of 47 metres . Araria is situated at the northern part of Purnia and Madhepura in Bihar...

     district in the state of Bihar
    Bihar
    Bihar is a state in eastern India. It is the 12th largest state in terms of geographical size at and 3rd largest by population. Almost 58% of Biharis are below the age of 25, which is the highest proportion in India....

    , India. She had four arms and four legs, resulting from a joining at the pelvis with a headless undeveloped parasitic twin. Some of the local villagers have hailed her as the reincarnation of Lakshmi
    Lakshmi
    Lakshmi or Lakumi is the Hindu goddess of wealth, prosperity , light, wisdom, fortune, fertility, generosity and courage; and the embodiment of beauty, grace and charm. Representations of Lakshmi are also found in Jain monuments...

    , the multi-limbed Hindu goddess. In November 2007 she successfully underwent surgery to remove the parasitic twin.
  • Jade and Erin Buckles, born February 26, 2004, United States. Separated in June 2004.
  • Ram and Laxman born in Chhattisgarh, India in 2006, successfully separated at MCHR, Raipur, CG.
  • Emma and Taylor Bailey were born September 20, 2006 and died after complications encountered during surgery to increase the pressure in their shared heart on August 10, 2010. Arizona, USA
  • Krista and Tatiana Hogan
    Krista and Tatiana Hogan
    Krista Hogan and Tatiana Hogan are craniopagus conjoined twins. They are joined at the top, backs, and sides of their heads. They were born in Vancouver, British Columbia, Canada, and are the only unseparated craniopagus twins currently alive in Canada...

    , Canadian twins conjoined at the head. Born October 25, 2006.
  • Trishna and Krishna from Bangladesh were born around December, 2006, Craniopagus twins, joined on the tops of their skulls, and sharing a small amount of brain tissue. They were found in an orphanage, and their surname is not clear. On 16–17 November 2009, they were separated in Melbourne, Australia, in a 32-hour operation involving a surgical team of 16 led by Wirginia Maixner
    Wirginia Maixner
    Wirginia June Maixner is an Australian neurosurgeon and the director of neurosurgery at the Royal Children's Hospital in Melbourne, Australia...

    , director of neurosurgery at the Royal Children's Hospital
    Royal Children's Hospital, Melbourne
    The Royal Children's Hospital is a major children's hospital in Melbourne, Australia.As the major paediatric hospital in Victoria, the Royal Children's Hospital and offers a full range of clinical services, tertiary care and health promotion and prevention programs for children and adolescents...

     in Melbourne. Doctors had not only to separate shared brain tissue, but perform plastic surgery to close up the girls' skulls. A series of earlier operations had been performed to separate shared blood vessels and to insert tissue expanders
    Tissue expansion
    Tissue expansion is a technique used by plastic and restorative surgeons to cause the body to grow additional skin, bone or other tissues.-Skin expansion:...

     in preparation for the final separation.
  • Alex and Angel Mendoza were born in the summer of 2008 and were joined from below their sternums to their pelvises. They were successfully separated in January 2009.
  • Faith and Hope Williams born in London, England, on November 26, 2008; the girls were joined from the breastbone to the navel. On December 2, 2008 they underwent an operation to separate them at Great Ormond Street Hospital
    Great Ormond Street Hospital
    Great Ormond Street Hospital for Children is a children's hospital located in London, United Kingdom...

     in London. On December 3 Hope died. Faith died 23 days after her sister on Christmas Day.
  • Jayden and Joshua Chamberlain were born in July 2009 in London, joined face to face with a shared liver and fused heart. Joshua was stillborn and Jayden died 30 minutes after the birth. Separation was previously considered too risky to undertake due to the extent at which the boys' hearts were connected.
  • Milagros and Ruth Guelac born in Lima
    Lima
    Lima is the capital and the largest city of Peru. It is located in the valleys of the Chillón, Rímac and Lurín rivers, in the central part of the country, on a desert coast overlooking the Pacific Ocean. Together with the seaport of Callao, it forms a contiguous urban area known as the Lima...

    , Peru on October 22, 2009. They shared one heart and intestines, so they were impossible to separate.
  • Hassan and Hussein Benhaffaf were born on December 2, 2009 at University College Hospital, London and then transferred to Great Ormond Street Hospital, London where they were successfully separated in March 2010. Their parents are natives of Cork, Ireland.
  • Kauany Aparecida and Keroly Joice born in Campo Grande
    Campo Grande
    -Climate:Campo Grande has a highland tropical climate, semi-humid, hot, and notably seasonal, with a dry winter season from May through September or October. Under the Koppen climate classification Campo Grande features a tropical wet and dry climate, albeit a noticeably cooler version of the...

    , Brazil on March 5, 2010. They share one thorax
    Thorax
    The thorax is a division of an animal's body that lies between the head and the abdomen.-In tetrapods:...

     and one abdomen
    Abdomen
    In vertebrates such as mammals the abdomen constitutes the part of the body between the thorax and pelvis. The region enclosed by the abdomen is termed the abdominal cavity...

    .
  • Hanna Yaneth and Hanna Yineth born in Panama
    Panama
    Panama , officially the Republic of Panama , is the southernmost country of Central America. Situated on the isthmus connecting North and South America, it is bordered by Costa Rica to the northwest, Colombia to the southeast, the Caribbean Sea to the north and the Pacific Ocean to the south. The...

    . They shared the liver
    Liver
    The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

     and were connected though the abdomen. They were separated successfully on September 28, 2010. Hanna Yineth's kidney never worked after the separation and on October 10 died as a result of a cardiac arrest
  • Joshua and Jacob Spates were pygophagic twins born on 24 January 2011 at the Regional Medical Center Newborn Center in Memphis, Tennessee, and transferred 7 hours after birth by LeBonheur Children's Medical Center's Pediflite transport team to LeBonheur's NICU, where they spent 7 months before being separated on 29 August 2011. Both children had multiple cardiac and congenital defects that required progressive surgical correction.
  • A pair female twins, born October 12, 2011 in Sóc Trăng Province, Vietnam, was found dicephalic conjoined with two heads, two legs and three arms. The third arm lies on the back of their body and has only 3 fingers.

Conjoined Triplets

There have been two documented cases of Conjoined Triplets:

Unidentified (Sicily, Italy, 1834) 3 boys born with a single torso, two hearts, two stomachs, two lungs & three heads. The case was profiled in Gould & Pyle's Curiosities of Medicine.

Unidentified (Samsun, Turkey, 1955) Three heads, two pairs of arms, two pairs of legs; lived for 2 hours. On autopsy four lungs, three livers, three brains, two hearts and two kidneys were found. Information appeared in Sexology Magazine in 1955, they cited the Journal of the American Medical Association for the information.

There have been 43 sets of triplets born with 2 conjoined, with only 6 of those sets have all three babies survive. There has also been one case of quadruplets where two of the babies were conjoined, born in Totsaas, Norway, September 5 1953. Both died at birth.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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