Anesthetic Management Of Pygopagus Conjoined Twins: Techniques To Evaluate Cross-Circulation

Given the associated intricacies associated with surgery and anesthetic management, the care of conjoined twins requires a multidisciplinary approach. Due to the complexity of these patients, anesthetic care may be required for radiologic imaging, placement of tissue expanders, insertion of permanent or temporary vascular access devices, and definitive separation surgery. We present a case of pygopagus conjoined twins with multiple anesthetic encounters, including definitive separation surgery. The perioperative management of such patients, with emphasis on the shared circulation and airway management, is discussed.