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Conjoined twins fused at the abdomen (omphalopagus)

This photo was sent by a follower from Turkey, showing a union in a transverse plane in the lower body area, so that the twins face each other. In broad terms, conjoined twins can be regarded as a doubling anomaly. The later the incomplete embryologic separation occurs, the higher the likelihood of a complicated fusion. It is more precisely refers to an incomplete splitting of the monozygotic twins after 12 days of embryogenesis, ending with the fetuses being physically joined at some point. That point of union is used to classify twins. This is a case of a omphalopagus presentation, where the anterior abdomens are united combined with the union of a small portion of the lower chest. This can present with or without a cardiac union. Separating twins with a conjoined heart is a real surgical challenge. As for any type of anomaly, the anatomy of the junction and the shared organs and structures dictate the specific details of the procedure.Photo by @intdocy