Conjoined twins

"Siamese twins" redirects here. For other uses, see Siamese twins (disambiguation).

Conjoined twins

Other names| Siamese twin
X-ray of conjoined twins, Cephalothoracopagus.
Symptoms| Bodies fused
Complications| Depends on type
Usual onset| Beginning of pregnancy
Duration| Lifelong
Types| See article
Causes| Incomplete fission
Treatment| Surgery, symptomatic care
Prognosis| Depends on type; occasionally may survive
Conjoined twins (War Remnants Museum)

Conjoined twins, popularly referred to as Siamese twins,[1][2] are twins joined in utero.[lower-alpha 1] It is a very rare phenomenon, estimated to occur in anywhere between one in 50,000 births to one in 200,000 births, with a somewhat higher incidence in southwest Asia and Africa.[5] Approximately half are stillborn, and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1.[5][6]

Two possible explanations of the cause of conjoined twins have been proposed. The one that is generally accepted is fission, in which the fertilized egg splits partially.[7] The other explanation, no longer believed to be accurate,[7] is fusion, in which the fertilized egg completely separates, but stem cells (that search for similar cells) find similar stem cells on the other twin and fuse the twins together. Conjoined twins and some monozygotic, but not conjoined, twins share a single common chorion, placenta, and amniotic sac in utero.[8]

Chang and Eng Bunker (1811–1874) were brothers born in Siam (now Thailand) who traveled widely for many years and were known internationally as the Siamese Twins. Chang and Eng were joined at the torso by a band of flesh and cartilage, and by their fused livers. In modern times, they could easily have been separated.[9] Due to the brothers' fame and the rarity of the condition, the term Siamese twins came to be associated with conjoined twins.

## Contents

* 1 Causes
* 2 Types
* 3 Treatment
* 3.1 Separation
* 4 History
* 5 Notable people
* 5.1 Born 19th century and earlier
* 5.2 Born 20th century
* 5.3 Born 2000s
* 5.4 Born 2010s
* 5.5 Born 2020s
* 6 In fiction
* 7 See also
* 8 Notes
* 9 References
* 10 External links

## Causes

There are two hypotheses about the development of conjoined twins.

1. a single fertilized egg does not fully split during the process of forming identical twins. If the zygote division occurs after two weeks of the development of the embryonic disc, it results in the formation of conjoined twins.[10]
2. fusion of two fertilized eggs occurs early in development.

Partial splitting of the primitive node and streak may result in the formation of conjoined twins. These twins are classified according to the nature and degree of their union. Occasionally, monozygotic twins are connected only by a common skin bridge or by a common liver bridge. The type of twins formed depends on when and to what extent abnormalities of the node and streak occurred. Misexpression of genes, such as goosecoid, may also result in conjoined twins.[11] Goosecoid activates inhibitors of BMP4 and contributes to regulation of head development. Over- or underexpression of this gene in laboratory animals results in severe malformations of the head region, including duplications, similar to some types of conjoined twins.[12]

## Types

Conjoined twins are typically classified by the point at which their bodies are joined. The most common types of conjoined twins are:

* Thoracopagus (28% of cases):[7] Two bodies fused from the upper chest to the lower chest. These twins usually share a heart and may also share the liver or part of the digestive system.[13] Survival rate is poor.[14]
* Thoraco-omphalopagus (18.5%):[7] Two bodies fused from the upper chest to lower belly. The heart is always shared in these cases.[13] As of 2015[update], twins who share a heart have not been able to both survive separation; a designated twin who is allotted the heart may survive if the other twin is sacrificed.
* Omphalopagus (10%):[7] Two bodies fused at the lower abdomen. Unlike thoracopagus, the heart is not shared; however, the twins often share a liver, a digestive system, a diaphragm and other organs.[13] Survival rate is 82%.[14]
* Heteropagus[15] (parasitic twin) (10%):[7] Twins that are asymmetrically conjoined, resulting in one twin that is small, less formed, and dependent on the larger twin's organs for survival.
* Craniopagus (6%):[7] Fused skulls, but separate bodies. These twins' heads may be conjoined at the back, front, or side of the head, but not on the face or at the base of the skull.[13] Survival rate is poor.[14]

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. This is also known as janiceps (after the two-faced Roman deity Janus).[13]
* Syncephalus: One head with a single face but four ears and two bodies.[13]
* Cephalothoracopagus: Bodies fused at the head and thorax, with two faces facing in opposite directions, or sometimes with a single face and an enlarged skull.[13][16]
* Xiphopagus: Two bodies fused in the xiphoid cartilage, which extends approximately from the navel to the lower breastbone. These twins almost never share any vital organs, with the exception of the liver.[13] A famous example is Chang and Eng Bunker.
* Ischiopagus: Fused lower half of the two bodies, with spines conjoined end-to-end at a 180° angle. These twins have four arms; one, two, three or four legs; and typically one set of external genitalia and one anus.[13] Survival rate is 63%.[14]
* Omphalo-ischiopagus: Fused in a similar fashion to ischiopagus twins, but facing each other, with a joined abdomen, akin to omphalopagus. These twins have four arms, and two, three, or four legs.[13]
* Parapagus: Fused side by side with a shared pelvis. Those that are dithoracic parapagus are fused at the abdomen and pelvis, but not at the thorax. Those that are diprosopic parapagus have one trunk and two faces. Those that are dicephalic parapagus have one trunk and two heads, and may have two (dibrachius), three (tribrachius), or four (tetrabrachius) arms.[13] Survival rate is poor.[14]
* Craniopagus parasiticus: Like craniopagus, but with a second bodiless head attached to the dominant head.
* Pygopagus or Iliopagus: Two bodies joined at the pelvis.[13] Survival rate is 68%.[14]
* Rachipagus: Twins joined along the back of their bodies, with fusion of the vertebral arches and the soft tissue from the head to the buttocks.[17] Twins of this type cannot be separated.[14]
* Tricephalus (conjoined triplets): Extremely rare conjoining of 3 fetuses. Very few confirmed cases, both human and animal, are known.[18]

## Treatment

### Separation

Surgery to separate conjoined twins may range from very easy to very difficult depending on the point of attachment and the internal parts that are shared.[19] Most cases of separation are extremely risky and life-threatening. Though there have been a number of successful separations throughout history, in many cases, the surgery results in the death of one or both of the twins, particularly if they are joined at the head or share a vital organ. This makes the ethics of surgical separation, where the twins can survive if not separated, contentious. Alice Dreger of Northwestern University found the quality of life of twins who remain conjoined to be higher than is commonly supposed.[20] Lori and George Schappell and Abby and Brittany Hensel are notable examples.

The first recorded separation of conjoined twins took place in the Byzantine Empire in the 900s. One of the conjoined twins had already died, so the doctors of the town attempted to separate the dead twin from the surviving twin. The result was briefly successful, as the remaining twin lived for three days after separation. The next recorded case of separating conjoined twins was several centuries later, in Germany, in 1689.[21][22] The first recorded successful separation of conjoined twins was performed in 1689 by Johannes Fatio.[23] Around this same time Dr. Böhm of Gunzenhausen separated his own children, a pair of omphalopagus or xiphopagus twins; the feebler twin died four days later, but the healthier one was still alive and well at age five, when the case was reported.[24] In 1955, neurosurgeon Harold Voris (1902-1980)[25] and his team at Mercy Hospital in Chicago performed the first successful operation to separate craniopagus twins (conjoined at the head), which resulted in long-term survival for both.[26][27][28] The larger girl was reported in 1963 as developing normally, but the smaller girl was permanently impaired.[29]

In 1957, Bertram Katz and his surgical team made international medical history performing the world's first successful separation of conjoined twins sharing a vital organ.[30] Omphalopagus twins John Nelson and James Edward Freeman (Johnny and Jimmy) were born in Youngstown, Ohio, on April 27, 1956. The boys shared a liver but had separate hearts and were successfully separated at North Side Hospital in Youngstown, Ohio, by Bertram Katz. The operation was funded by the Ohio Crippled Children's Service Society.[31]

Other successful separations of conjoined twins include that of the separation of Ganga and Jamuna Shrestha in 2001, who were born in Kathmandu, Nepal, in 2000. The 97-hour surgery on the pair of craniopagus twins was a landmark one which took place in Singapore; the team was led by neurosurgeons Chumpon Chan and Keith Goh.[32] The surgery left Ganga with brain damage and Jamuna unable to walk. Seven years later, Ganga Shrestha died at the Model Hospital in Kathmandu in July 2009, at the age of eight, three days after being admitted for treatment of a severe chest infection.[33]

Infants Rose and Grace Attard, conjoined twins from Malta, were separated in the United Kingdom by court order Re A over the religious objections of their parents, Michaelangelo and Rina Attard. The twins were attached at the lower abdomen and spine. The surgery took place in November 2000, at St Mary's Hospital in Manchester. The operation was controversial because Rose, the weaker twin, would die as a result of the procedure as her heart and lungs were dependent upon Grace's. However, if the operation had not taken place, it was certain that both twins would die.[34][35] Grace survived to enjoy a normal childhood.[36]

In 2003, two 29-year-old women from Iran, Ladan and Laleh Bijani, 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. Their complex case was accepted only because technologically advanced graphical imagery and modeling would allow the medical team to plan the risky surgery. However, an undetected major vein hidden from the scans was discovered during the operation.[37] The separation was completed but both women died while still in surgery.

In 2019, Safa and Marwa Ullah were separated at Great Ormond Street Hospital in London, England. The twins, born January 2017, were joined at the top of the head with separate brains and a cylindrical shared skull with the twins each facing in opposite directions to one another. The surgery was jointly led by neurosurgeon Owase Jeelani and plastic surgeon Professor David Dunaway. The surgery presented particular difficulties due to a number of shared veins and a distortion in the shape of the girls' brains, causing them to overlap. The distortion would need to be corrected in order for the separation to go ahead. The surgery utilized a team of more than 100 including bio engineers, 3D modelers and a virtual reality designer. The separation was completed in February 2019 following a total of 52 hours of surgery over three separate operations. The family returned to their home in Pakistan in October 2020, though one of the twins had a stroke during surgery which could make her unable to walk for the rest of her life.[38][39][40]

## History

Conjoined brothers from Nuremberg Chronicle (1493) Conjoined twin sisters from Nuremberg Chronicle (1493) Moche ceramics depicting conjoined twins. 300 AD Larco Museum Collection Lima, Peru

The Moche culture of ancient Peru depicted conjoined twins in their ceramics dating back to 300 AD.[41] Writing around 415 AD, St. Augustine of Hippo, in his book, City of God, refers to a man "double in his upper, but single in his lower half—having two heads, two chests, four hands, but one body and two feet like an ordinary man."[42]

According to Theophanes the Confessor, a Byzantine historian of the 9th century, around 385/386 AD, he writes that "in the village of Emmaus in Palestine, a child was born perfectly normal below the navel but divided above it, so that it had two chests and two heads, each possessing the senses. One would eat and drink but the other did not eat; one would sleep but the other stayed awake. There were times when they played with each other, when both cried and hit each other. They lived for a little over two years. One died while the other lived for another four days and it, too, died."[43]

In Arabia, the twin brothers Hashim ibn Abd Manaf 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, separated his conjoined sons with a sword and that some priests believed that the blood that had flowed 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).[44] The Muslim polymath Abū al-Rayhān al-Bīrūnī described conjoined twins in his book Kitab-al-Saidana.[45]

The English twin sisters Mary and Eliza Chulkhurst or Chalkhurst, commonly known as the Biddenden Maids after the village where they are believed to have lived, were conjoined at the back (pygopagus). They reputedly lived from 1100 to 1134 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; and Rita and Cristina of Parodi of Sardinia, 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.

Grave of Eng and Chang Bunker near Mt. Airy, North Carolina

Several sets of conjoined twins lived during the nineteenth century and made careers for themselves in the performing arts, though none achieved quite the same level of fame and fortune as Chang and Eng. Most notably, Millie and Christine McCoy (or McKoy), pygopagus twins, were born into slavery in North Carolina in 1851. They were sold to showman 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, 17 hours apart.

Giacomo and Giovanni Battista Tocci, from Locana, Italy, were immortalized in Mark Twain's short story "Those Extraordinary Twins" as fictitious twins Angelo and Luigi. The Toccis, born between 1875 and 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 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. Reports confirm that they were alive and married in 1904, but subsequent reports are contradictory about whether they were alive or whether they had children. They retired in Italy.

## Notable people

### Born 19th century and earlier

Eng (left) and Chang (right) in later years

* Mary and Eliza Chulkhurst, alleged names of the Biddenden Maids (per tradition, born in the 12th century) of Kent, England.[46] They are the earliest set of conjoined twins whose names are (purportedly) known.
* Lazarus and Joannes Baptista Colloredo (1617 – after 1646), autosite-and-parasite pair
* Chang and Eng Bunker (1811–1874). The Bunker twins were born of Chinese origin in Siam (now Thailand), and the expression Siamese twins is derived from their case. They were joined by the areas around their xiphoid cartilages, but over time, the connective tissue stretched.
* In 1834, a set of conjoined triplets were born in Catania. Two of the heads shared a neck while the other head had its own. The infant, a male, was described by Galvagni.[47]
* Millie and Christine McCoy (July 11, 1851 – October 8, 1912), (oblique pygopagus). The McCoy twins were born into slavery in Columbus County, North Carolina, United States. They went by the stage names "The Two-Headed Nightingale" and "The Eighth Wonder of the World" and had an extensive career before retiring to the farm on which they were born.
* Giacomo and Giovanni Battista Tocci (1875? — 1912?), (dicephalus tetrabrachius dipus)
* Josefa and Rosa Blazek (January 20, 1878 — March 30, 1922),[48] pygopagus.[49] The Blazek twins were born in Skrejšov, Bohemia (now the Czech Republic).[49] They began performing in public exhibitions at the age of 13, and their act later included Rosa's son Franz. The sisters died in Chicago, Illinois.[50]

### Born 20th century

* Daisy and Violet Hilton of Brighton, England (1908–1969), pygopagus. The Hilton twins were performers who played musical instruments, sang, and danced. At the height of their career, they had the highest paid act in vaudeville.[51] They also appeared in the movies Freaks and Chained for Life.
* Lucio and Simplicio Godina of Samar, Philippines (1908–1936)
* Mary and Margaret Gibb of Holyoke, Massachusetts (1912–1967)[52]
* Masha and Dasha Krivoshlyapova of Moscow, Russia (1950–2003), the rarest form of conjoined twins, one of few cases of dicephalus tetrabrachius tripus (two heads, four arms, three legs)
* Ronnie and Donnie Galyon of Ohio (1951–2020), omphalopagus; longest-lived conjoined twins in the world at 68 years and 250 days.
* Tjitske and Folkje de Vries of Mûnein, Netherlands (b. 1953), successfully separated in 1954[53]
* Wariboko and Tamunotonye Davies, born July 25, 1953, in Kano, Nigeria. Separated in London by a team led by Ian Aird. Tamunotonye died postoperatively. Wariboko became a nurse.[54]
* Lillian and Linda Matthews, born in Indianola, Mississippi on September 14, 1955. They were conjoined from sternum to navel and were separated at five weeks old, making them one of the world's first successfully separated sets of conjoined twins. Both women graduated from Mississippi Valley State University and work as teachers.[55][56]
* Lori and George Schappell of Reading, Pennsylvania (1961–2024), American entertainers, craniopagus. At the time of their death, they were the world's oldest living conjoined twins.[57] Guinness World Records noted that George's gender transition made him and Lori the first same-sex conjoined twins to identify as different genders.[58]
* Ganga and Jamuna Mondal of India, born 1969 or 1970, known professionally as The Spider Girls and The Spider Sisters. Ischiopagus.
* Anna and Barbara Rozycki (born 1970), the first conjoined twins successfully separated in the UK.[59]
* Elisa and Lisa Hansen, Ogden, Utah (1977). Born by Caesarean section on October 18, 1977, were conjoined at the top of their head (craniopagus). They were separated 1979 after 16-hour surgery, were first to both survive surgery.[60] Elisa lost the use of her right side after the surgery, but went on to complete school, win medals in the Special Olympics, work, and act in the theatre. Elisa and Lisa died in 2020 (age 42).[61][62]
* Ladan and Laleh Bijani of Shiraz, Iran (1974–2003); died during separation surgery in Singapore. Craniopagus.
* Chang Chung-jen and Chung-i, born on December 23, 1976 in Taiwan, and separated in 1979. Both babies survived. It was the first successful separation in Taiwan, and the fourth in the world. Chang Chung-jen died in 2019 and Chang Chung-i is still alive.[63]
* Baby Girl A and Baby Girl B (born 1977 in New Jersey) shared a single six-chambered heart. Separation surgery would result in the certain death of Baby Girl A, while offering a remote chance of survival for Baby Girl B. The difficult ethical and religious concerns generated significant local newspaper coverage, as without the surgery, both twins faced certain death. C. Everett Koop, who had already performed two successful separation surgeries in the past, held lengthy discussions with the family and their team of rabbinical advisors. At the family's request, and after obtaining a court order protecting him from any possible criminal liability, Koop agreed to lead the surgery; Koop did not seek civil indemnification for himself beforehand. Baby Girl B survived for three months, before infections led to liver failure, resulting in her death.[64]
* Viet and Duc Nguyen, born on February 25, 1981, in Kon Tum Province, Vietnam, and separated in 1988 in Ho Chi Minh City. Viet died on October 6, 2007. Ischiopagus.
* Maria and Consolata Mwakikuti of Tanzania (1996–2018); conjoined by the abdomen; died of respiratory problems resulting from an abnormal, inoperable chest deformity.[65][66]
* Patrick and Benjamin Binder, separated in 1987 by team of doctors led by Ben Carson. Craniopagus.
* Andrew and Alex Olson, born in 1987, separated in April 1988 at the University of Nebraska Medical Center. Omphalopagus. Alex died in 2018.[67]
* Katie and Eilish Holton, born August 1988 in Ireland, separated at age 3 and a half. Katie died 4 days after the separation surgery due to a weak heart which went into cardiac arrest.[68]
* Abigail and Brittany Hensel are dicephalic parapagus twins born on March 7, 1990, in Carver County, Minnesota. Both graduated in 2012 from Bethel University, St. Paul, hired as teachers.
* Ashley and Ashil Fokeer, born on November 2, 1992, in Mauritius[69]
* Joseph and Luka Banda (born January 23, 1997, in Zambia), separated in 1997 in South Africa by Ben Carson (with a later intervention in 2001 to artificially close their skulls). Craniopagus.
* José Armando and José Luis Cevallos Herrera were born in September 1999 in Milagro, Ecuador. They were accepted in 2021 to the State University of Milagro.[70]

### Born 2000s

* Maria del Carmen (Carmen) and Maria Guadalupe (Lupita) Andrade Solis were born in June 2000 in Veracruz, Mexico. They later moved to the United States for healthcare with their parents.[71]
* Maria de Jesus (Josie) and Maria Teresa (Teresita) Alvarez, born joined at the skull as craniopagus twins in Guatemala in 2001, were brought to UCLA Medical Center by Medical Kids International in 2002 and successfully separated.[72]
* Sheneeva and Chenelva Kolestein, born in Suriname in 2001 and living in the Netherlands. They are joined at the head and share vital arteries that make separation impossible.[73]
* Mackenzie and Macey Garrison, born in December 2002 and successfully separated at Children's Hospital Los Angeles in 2003. They were conjoined at the pelvis and are part of a set of triplets; their sister Madeline is unaffected.[74]
* Carl and Clarence Aguirre, born with vertical craniopagus in Silay City, Negros Occidental, on April 21, 2002. They were successfully separated on August 4, 2004.[75]
* Tabea and Lea Block, from Lemgo, Germany, were born as craniopagus twins joined on the tops of their heads on August 9, 2003. The girls shared some major veins, but their brains were separate. They were separated on September 16, 2004, although Tabea died about ninety minutes later.[76]
* Sohna and Mohna from Amritsar, India. Born in New Delhi on June 14, 2003. They have two hearts, arms, kidneys and spinal cords while share liver, gall bladder and legs.[77]
* Anastasia and Tatiana Dogaru, born outside Rome, Italy, on January 13, 2004. As craniopagus twins, the top of Tatiana's head is attached to the back of Anastasia's head.
* Erin and Jade Buckles were born in February 2004. They were joined from their chests to their abdomens and shared a liver. They were successfully separated at four months old, though it resulted in Erin's paralysis from the chest down due to a spinal stroke during surgery.[78][79]
* Lakshmi Tatma (born 2005) was an ischiopagus conjoined twin born in Araria district in the state of Bihar, India. She had four arms and four legs, resulting from a joining at the pelvis with a headless undeveloped parasitic twin.[80]
* In 2005, a set of conjoined triplets was detected, characterized as tricephalus, tetrabrachius, and tetrapus parapagothoracopagus, and the pregnancy interrupted at 22 weeks.[81]
* Kendra and Maliyah Herrin, ischiopagus twins separated in 2006 at age 4[82]
* Krista and Tatiana Hogan, Canadian twins conjoined at the head. Born October 25, 2006. Share part of their brain and can pass sensory information and thoughts between each other.
* Trishna and Krishna from Bangladesh were born in December 2006. They are craniopagus twins, joined on the tops of their skulls and sharing a small amount of brain tissue. In 2009, they were separated in Melbourne, Australia.[83]
* Angelica and Angelina Sabuco, born in the Philippines in 2009. Conjoined at the sternum, pericardium and liver. Successfully separated at Lucile Packard Children's Hospital on November 1, 2011 and now living in San Jose, California.[84]

### Born 2010s

* Maria and Teresa Tapia, born in the Dominican Republic on April 8, 2010. Conjoined by the liver, pancreas, and a small portion of their small intestine. Separation occurred on November 7, 2011, at Children's Hospital of Richmond at VCU.
* Amelia and Allison Tucker were born March 1, 2012 and remained in hospital at Children's Hospital of Philadelphia until their separation on November 7, 2012 at 8 months old. Born joined at the chest and abdomen, the twins shared a chest wall, liver, and diaphragm.[85]
* Zheng Hanwei and Zheng Hanjing, born in China on August 11, 2013. Conjoined by their sternum, pericardium, and liver. In 2014, they were separated in Shanghai, China, at the Shanghai Children's Medical Center.[86][87]
* Knatalye Hope and Adeline Faith Mata, born in Houston, Texas on April 11, 2014. They were conjoined at the chest and shared many internal organs, including their lungs and pericardium. They were successfully separated at Texas Children's Hospital on February 17, 2015.[88][89]
* Scarlett and Ximena Torres, born in Corpus Christi, Texas on May 16, 2015. Conjoined at the hips and shared a colon and bladders. They are part of a set of identical triplets; their sister Catalina was not impacted. They were successfully separated at Driscoll Children's Hospital in 2016.[90][91]
* Jadon and Anias McDonald, born in September 2015. Conjoined by the head. Successfully separated at Children's Hospital of Montefiore Medical Center by James T. Goodrich in October 2016. Anais had developmental delays following separation, while Jadon's development was less impacted.[92][93][94]
* Erin and Abby Delaney, born in Philadelphia, Pennsylvania, on July 24, 2016, conjoined by the head. The twins shared a skull, skin and superior sagittal sinus. They were successfully separated at Children's Hospital of Philadelphia on June 16, 2017. Both twins have experienced delays in development following separation [95][96]
* Anna and Hope Richards were born December 29, 2016, at Texas Children’s, conjoined at their chest and abdomen, sharing a chest wall, pericardial sac, diaphragm, liver, and a large blood vessel connecting their hearts. They were separated on January 13, 2017.[97]
* Marieme and Ndeye Ndiaye, twin girls born in Senegal in May 2016, living in Cardiff, UK in 2019. The twins share one pelvis and one pair of legs. After consultation with Great Ormond Street Hospital, it was determined both girls would not survive a separation, and parents have elected not to separate.[98][99]
* Callie and Carter Torres, born January 30, 2017, in Houston Texas, from Blackfoot Idaho. They are omphalo-ischiopagus conjoined twins, attached by their pelvic area and sharing all organs from the belly button down with just one leg each. Their parents have elected not to pursue separation surgery due to risks involved.[100][101]
* Yiğit and Derman Evrensel, twin boys born on June 21, 2018, Antalya, Turkey. They are craniopagus twins and were separated at Great Ormond Street Hospital in 2019 by the same surgeons that separated Safa and Marwa Bibi.[102][103]
* Ervina and Prefina Bangalo, born June 29, 2018, in the Central African Republic. They were separated on June 5, 2020, at the Bambino Gesù Pediatric Hospital in Rome, Italy.[104]
* Mercy and Goodness Ede, born August 13, 2019, conjoined by the chest and abdomen. Successfully separated at the National Hospital in Abuja, Nigeria in November 2019.[105]
* Hassanatu "Maggie" and Hussainatu "Chelsea" Jolloh, born in Sierra Leone on September 11, 2019. Conjoined at the chest and had a fused pericardium and liver. Their triplet brother, Chernor, died shortly after birth. They were successfully separated at the Morgan Stanley Children's Hospital in New York City on February 21, 2020.[106]
* Marie-Cléa and Marie-Cléanne Papillon, born in Mauritius in 2019.[107] Conjoined from neck to abdomen, but also at the heart, which had seven chambers, instead of four.[108] Marie-Cléa did not survive the surgery to separate the two.[109]
* Valentina and Kristina, born in 2019 in Croatia, shared a part of the digestive system and liver (xypho-omphalopagus). Several months after birth they developed twin-to-twin transfusion syndrome due to blood shunting, and they were successfully separated at University Hospital Centre Zagreb (Rebro) in an urgent procedure.[110][111]
* Sarabeth and Amelia Irwin were born June 11, 2019, sharing a chest wall, sternum, pericardium and liver. They were separated at Mott Children's Hospital on August 5, 2020.[112]
* Remi and Reese Erickson were born in Minnesota in November 2019. They shared a chest wall, abdomen, liver, part of the pelvis, and umbilical cord. They were separated at Children's Minnesota on April 9, 2020. Reese has lasting medical and developmental disabilities; Remi has developed typically.[113][114]
* Abigail and Micaela Bachinskiy, born December 30, 2019 in Sacramento, California and conjoined at the head. They were successfully separated in October 2020 in a surgery that lasted over 24 hours.[115]

### Born 2020s

* Lily and Addy Altobelli, born in Philadelphia, Pennsylvania on November 18, 2020. Conjoined at the liver and diaphragm. Separated at Children's Hospital of Philadelphia on October 13, 2021.[116]
* Susannah and Elizabeth Castle, born April 22, 2021, and separated December 10, 2021, in Philadelphia, Pennsylvania. They shared a liver, part of their digestive tract and small intestines.[117]
* Lucas and Mateo Villalobos Barrera were born on January 18, 2022, connected at the lower abdomen and pelvis and sharing small intestines and a single colon (ischiopagus). The boys were successfully separated on August 17, 2022 at Texas Children's Hospital.[118]
* Annabelle and Isabelle Bateson, who are from Ireland, were born March 2022 in London, joined at the chest to pelvis and sharing a liver, bladder, and bowel. The girls were born with two normal legs and a third fused leg that was removed during separation. Following their birth, they underwent successful separation surgery in September 2022 at Great Ormond Street Hospital.[119][120]
* AmieLynn Rose and JamieLynn Rae Finley, born October 3, 2022, and separated January 23, 2023, in Fort Worth, Texas. They were the first conjoined twins to be separated at Cook Children's Medical Center. They were joined at the abdomen and shared a liver.[121]
* Ella and Eliza Fuller were born at Texas Children’s on March 1, 2023 and were conjoined at the abdomen, sharing a liver. The sisters were surgically separated on June 14, 2023.[122][123]
* Amelia and Elhora Dell were born on February 29, 2024. The girls shared a single heart. The girls survived for an hour following their birth.[124]
* Amari and Javar Ruffin were born on September 29, 2023, weighing three pounds (about 1.5 lbs. each), sharing their sternum, diaphragm, abdominal wall, and liver. They spent 10 months at the Children's Hospital of Philadelphia before being successfully separated on August 21, 2024.[125]

## In fiction

Conjoined twins have been the focus of several works of fiction, including:

* Robert A. Heinlein's Orphans of the Sky features Joe-Jim Gregory, the two-headed leader of a powerful mutie gang, who understands the Ship's nature better than anyone else onboard.
* The TV show Dragon Tales contains a two-headed brother and sister dragon, Zak & Wheezie.
* Lori Lansens's second novel The Girls (2005) is the life story of craniopagus twin sisters.
* Irish author Sarah Crossan's verse novel One follows the life and survival of conjoined twin sisters. It won the Carnegie Medal, The Bookseller's 2016 prize for young adult fiction, and the Irish Children's Book of the Year.[126]
* Lidija Dimkovska's A Spare Life (mk) (Резервен живот), 2012, translated into English by Christina E. Kramer, Two Lines Press, San Francisco, USA, 2016, tells of two conjoined sisters growing up in Macedonia just before the breakup of Yugoslavia.
* The first-person psychological survival horror game, The Outlast Trials (2024), received a major update on July 15th, 2025, under the name of Project Diarchy, featuring a new set of antagonists, cojoined fraternal twin brother and sister, Otto and Arora Kress.
* In the multiplayer asymmetrical horror game Identity V, Ivy (also known as "The Shadow"), one of the playable characters, is a surgically separated conjoined twin.
* In the Warhammer franchise by Games Workshop, Kairos Fateweaver (Also known as the "Oracle of Tzeentch") is a Lord of Change, represented by an anthropomorphic raven with two heads as a result of being thrown into the Well of Eternity. The left head can see all possible futures, and the right the unbiased past, but are both blind to the immediate present.
* Katherine Dunn's novel Geek Love features conjoined twin sisters named Electra and Iphigenia, described as such by their younger sister, the book's protagonist, Olympia: "The girls were Siamese twins with perfect upper bodies joined at the waist and sharing one set of hips and legs. They usually sat and walked and slept with their long arms around each other. They were, however, able to face directly forward by allowing the shoulder of one to overlap the other... If you pulled Elly's hair, Iphy yelped too. If you kissed Iphy's cheek, Elly smiled."

## See also

* Medical law
* Monoamniotic twins
* Polycephaly

## Notes

1. ↑ Conjoined twins are almost universally assumed to always be monozygotic, but dizygotic conjoined twins are theoretically possible.[3][4]

## References

1. ↑ "conjoined twin" (in en). https://www.britannica.com/science/conjoined-twin.
2. ↑ "Medical Definition of Conjoined twin" (in en). https://www.medicinenet.com/conjoined_twin/definition.htm.
3. ↑ Maymon, Ron; Mendelovic, Sonia; Schachter, Morey; Ron-El, Raphael; Weinraub, Zwi; Herman, Arie (September 2005). "Diagnosis of conjoined twins before 16 weeks' gestation: The 4-year experience of one medical center". Prenatal Diagnosis 25 (9): 839–843. doi:10.1002/pd.1274. PMID 16170850. https://cris.tau.ac.il/en/publications/diagnosis-of-conjoined-twins-before-16-weeks-gestation-the-4-year.
4. ↑ Schiewe, Mitchel C.; Whitney, John B.; Anderson, Robert E. (February 1, 2015). "Potential risk of monochorionic dizygotic twin blastocyst formation associated with early laser zona dissection of group cultured embryos". Fertility and Sterility 103 (2): 417–421. doi:10.1016/j.fertnstert.2014.11.009. PMID 25516079. https://www.fertstert.org/article/S0015-0282(14)02355-3/fulltext. "one could predict dizygotic conjoined twins occurring less than 1 in every 4.7 billion ovulation cycles".
5. ↑ 5.0 5.1 Carnevale, Francisco Cesar; Borges, Marcus Vinicius; Affonso, Breno Boueri; Pinto, Ricardo Augusto de Paula; Tannuri, Uenis; Maksoud, João Gilberto (April 2006). "Importance of angiographic study in preoperative planning of conjoined twins: case report". Clinics 61 (2): 167–70. doi:10.1590/S1807-59322006000200013. PMID 16680335.
6. ↑ Conjoined Twins at eMedicine
7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 Kaufman, M.H. (August 2004). "The embryology of conjoined twins". Child's Nervous System 20 (8–9): 508–25. doi:10.1007/s00381-004-0985-4. PMID 15278382.
8. ↑ Tao Le; Bhushan, Vikas; Vasan, Neil (2010). First Aid for the USMLE Step 1: 2010 20th Anniversary Edition. USA: The McGraw-Hill Companies, Inc.. p. 121. ISBN 978-0-07-163340-6. https://archive.org/details/firstaidforusmle0000unse_r6p4/page/121.
9. ↑ "h2g2 – Twins – A369434". Bbc.co.uk. https://www.bbc.co.uk/dna/h2g2/alabaster/A369434.
10. ↑ Konar, Hiralal (May 10, 2015). DC Dutta's textbook of obstetrics (Eighth ed.). JP Medical. p. 233. ISBN 9789351527237.
11. ↑ Sadler, Thomas W. (October 29, 2018). Langman's medical embryology (14th ed.). Wolters Kluwer. p. 124. ISBN 9781496383907.
12. ↑ Sadler, Thomas W. (October 29, 2018). Langman's medical embryology (14th ed.). Wolters Kluwer. p. 63. ISBN 9781496383907.
13. ↑ 13.00 13.01 13.02 13.03 13.04 13.05 13.06 13.07 13.08 13.09 13.10 13.11 Burmagina, Yuliya (March 1, 2006). "Duplicata incompleta, dicephalus dipus dibrachius". http://www.thefetus.net/page.php?id=1494.
14. ↑ 14.0 14.1 14.2 14.3 14.4 14.5 14.6 "Conjoined Twins: Definition, Causes & Outlook" (in en). https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins.
15. ↑ Sharma, Gaurav; Mobin, Sheila S. Nazarian; Lypka, Michael; Urata, Mark (December 2010). "Heteropagus (parasitic) twins: a review". Journal of Pediatric Surgery 45 (12): 2454–2463. doi:10.1016/j.jpedsurg.2010.07.002. ISSN 1531-5037. PMID 21129567.
16. ↑ "Cephalothoracopagus Menosymmetro (Conjoined Twins)". Mütter Museum, The College of Physicians of Philadelphia. http://www.collphyphil.org/virt_tour/museum_8.htm.
17. ↑ Spencer, Rowena (December 1995). "Rachipagus conjoined twins: They really do occur!". Teratology 52 (6): 346–356. doi:10.1002/tera.1420520605. PMID 8711621.
18. ↑ Oostra, Roelof-Jan; Schepens-Franke, Annelieke N.; Magno, Giovanni; Zanatta, Alberto; Boer, Lucas L. (2022-07-15). "Conjoined twins and conjoined triplets: At the heart of the matter" (in en). Birth Defects Research 114 (12): 596–610. doi:10.1002/bdr2.2066. ISSN 2472-1727. PMID 35766259.
19. ↑ Fallon, Sara C.; Olutoye, Oluyinka O. (2018-10-01). "The surgical principles of conjoined twin separation". Seminars in Perinatology. Conjoined Twins 42 (6): 386–392. doi:10.1053/j.semperi.2018.07.013. ISSN 0146-0005. PMID 30477661. https://www.sciencedirect.com/science/article/pii/S0146000518300521.
20. ↑ Dreger, Alice Domurat (2004). One of Us: Conjoined Twins and the Future of Normal. Harvard University Press. ISBN 978-0-674-01825-9. https://archive.org/details/oneofus00alic.
21. ↑ "The Case of Conjoined Twins in 10th Century Byzantium". January 4, 2014. http://www.medievalists.net/2014/01/the-case-of-conjoined-twins-in-10th-century-byzantium/.
22. ↑ Montandon, Denys (2015). "The unspeakable history of Thoracopagus twins' separation". ISAPS News 9 (3): 47–48. http://denysmontandon.com/wp-content/uploads/2016/01/conjoined-twins.pdf.
23. ↑ Kompanje, Erwin J. O. (December 1, 2004). "The First Successful Separation of Conjoined Twins in 1689: Some Additions and Corrections". Twin Research 7 (6): 537–541. doi:10.1375/1369052042663760. PMID 15607002.
24. ↑ Hirst, Barton Cooke; Piersol, George A. (George Arthur) (1891). Human monstrosities. University of Connecticut Libraries and Hartford Medical Society Historical Library. Philadelphia, Lea brothers & co.. http://archive.org/details/humanmonstrosities04hirs.
25. ↑ "Voris, Harold C.". The University of Chicago Photographic Archive. 1972. http://photoarchive.lib.uchicago.edu/db.xqy?one=apf1-08520.xml.
26. ↑ Stone, James L.; Goodrich, James T. (May 1, 2006). "The craniopagus malformation: classification and implications for surgical separation". Brain 129 (5): 1084–1095. doi:10.1093/brain/awl065. PMID 16597654.
27. ↑ "Mercy Care Firsts". https://www.mercy-chicago.org/mercy-firsts.
28. ↑ "Separate Siamese Twins!". Chicago Tribune. April 22, 1955. http://archives.chicagotribune.com/1955/04/22/page/1/article/separate-siamese-twins.
29. ↑ Voris, Harold C. (February 1963). "Cranioplasty in a Craniopagus Twin". Journal of Neurosurgery 20 (2): 145–147. doi:10.3171/jns.1963.20.2.0145. PMID 14192083.
30. ↑ "Dr. Bewrtram Katz, 83 – Obituary". http://www4.vindy.com/extra/tributes/905419781.html.
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33. ↑ "Nepali twin dies 7 years after 97-hour separation surgery". July 30, 2008. http://www.monstersandcritics.com/news/southasia/news/article_1420406.php/Nepali_twin_dies_7_years_after_97-hour_separation_surgery.
34. ↑ "Siamese twin Jodie "to go home soon"". BBC News. April 23, 2001. https://news.bbc.co.uk/2/hi/health/1292681.stm.
35. ↑ Appel, Jacob M. (September 2000). "Ethics: English High Court Orders Separation of Conjoined Twins". The Journal of Law, Medicine & Ethics 28 (3): 312–313. doi:10.1111/j.1748-720x.2000.tb00678.x. PMID 11210387.
36. ↑ "We don't know how to tell Gracie her sister died so she could live". The Mirror. July 9, 2007. http://www.thefreelibrary.com/We+don't+know+how+to+tell+Gracie+her+sister+died+so+she+could+live;...-a0166174616.
37. ↑ "Wired 11.10: Till Death Do Us Part". Wired. 2001-04-11. https://www.wired.com/wired/archive/11.10/twins_pr.html. Retrieved 2014-08-03.
38. ↑ "Conjoined twins return home after successful separation". October 19, 2020. https://www.bbc.com/news/health-54385415.
39. ↑ "The battle to separate Safa and Marwa". https://www.bbc.co.uk/news/extra/PLNMqvmycN/conjoined-twins.
40. ↑ "Separating conjoined twins" (in en). https://www.gosh.nhs.uk/news/separating-conjoined-twins.
41. ↑ Berrin, Katherine & Larco Museum. The Spirit of Ancient Peru:Treasures from the Museo Arqueológico Rafael Larco Herrera. New York: Thames and Hudson, 1997.
42. ↑ "CHURCH FATHERS: City of God, Book XVI (St. Augustine)". Newadvent.org. http://www.newadvent.org/fathers/120116.htm.
43. ↑ The Chronicle of Theophanes Confessor. Byzantine and Near Eastern History, AD 284–813. Translated with Introduction and Commentary by Cyril Mango and Roger Scott. Oxford: Clarendon Press, 1997, p. 106-107.
44. ↑ The Life of the Prophet Muhammad: Al-Sira Al-Nabawiyya By Ibn Kathir, Trevor Le Gassick, Muneer Fareed, pg. 132
45. ↑ A. Zahoor (1997), Abu Raihan Muhammad al-Biruni , Hasanuddin U
46. ↑ Bondeson, Jan (April 1992), "The Biddenden Maids: a curious chapter in the history of conjoined twins", Journal of the Royal Society of Medicine (London: Royal Society of Medicine Press) 85 (4): 217–221, doi:10.1177/014107689208500413, PMID 1433064
47. ↑ "Digital Collections - National Library of Medicine". https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-57221200R-bk#page/278/mode/2up/search/supernumerary+limbs.
48. ↑ Hartzman, Marc (2005) (in English). American Sideshow: An Encyclopedia of History's Most Wondrous and Curiously Stranger Performers. New York, NY: Jeremy P. Tarcher / Penguin. pp. 20–21. ISBN 978-1585425303.
49. ↑ 49.0 49.1 "The Double Monster Rosa-Josepha Blazek". The American Naturalist 25 (298): 891–894. 1891-10-01. doi:10.1086/275418. ISSN 0003-0147. Bibcode: 1891ANat...25..891.. https://www.journals.uchicago.edu/doi/10.1086/275418.
50. ↑ Breakstone, Benjamin H. (August 1922). "The Last Illiness of the Blazek Grown-Together Twins". Illinois Medical Journal 42: 123–130. https://books.google.com/books?id=n3I4AQAAMAAJ.
51. ↑ Miller, Sarah (2021) (in English). Violet and Daisy: The Story of Vaudeville's Famous Conjoined Twins. New York: Schwartz & Wade Books. p. 221. ISBN 978-0593119723.
52. ↑ Hartzman, Marc (2006). American Sideshow. East Rutherford: Penguin Publishing Group. pp. 159–160. ISBN 1585425303.
53. ↑ "Succesvol scheiden van een Siamese tweeling: het lukte in 1954 bij de Nederlandse Tjitske en Folkje" (in nl). 2019-08-05. https://eenvandaag.avrotros.nl/item/succesvol-scheiden-van-een-siamese-tweeling-het-lukte-in-1954-bij-de-nederlandse-tjitske-en-folkje/.
54. ↑ "WARIBOKO OKI @ 62: Nigeria's celebrated Siamese twin tells her life story" (in en-US). Vanguard (Lagos, Nigeria). 2015-12-12. https://www.vanguardngr.com/2015/12/wariboko-oki-62-nigerias-celebrated-siamese-twin-tells-her-life-story/.
55. ↑ communications (2023-09-06). "Alumni Spotlight: MVSU Alums, who were Born Conjoined Twins Share their Story of Life, Love and Survival" (in en). https://www.mvsu.edu/alumni-spotlight-mvsu-alums-who-were-born-conjoined-twins-share-their-story-life-love-and-survival.
56. ↑ "Successfully separated conjoined twins share life story 67 years later" (in en). 2023-03-03. https://www.today.com/parents/family/separated-conjoined-twins-share-life-story-rcna73230.
57. ↑ "6 Oldest Living Conjoined Twins in the World". September 5, 2019. https://www.oldest.org/people/living-conjoined-twins/. Retrieved June 21, 2022.
58. ↑ "First same-sex conjoined twins to identify as different genders". https://www.guinnessworldrecords.com/world-records/384329-first-conjoined-twins-to-identify-as-mixed-gender.
59. ↑ "UK's first separated conjoined twins forever grateful to NHS" (in en-GB). BBC News. 2023-07-05. https://www.bbc.com/news/uk-england-coventry-warwickshire-66103970.
60. ↑ "Utah Doctors Separate Siamese Twins Linked at Brain" (in en). The New York Times. 1979-05-31. https://www.nytimes.com/1979/05/31/archives/utah-doctors-separate-siamese-twins-linked-at-brain.html.
61. ↑ Services, Myers Mortuary & Cremation. "Obituary for Elisa Hansen | Myers Mortuary & Cremation Services" (in en). https://www.myers-mortuary.com/obituary/Elisa-Hansen.
62. ↑ Services, Myers Mortuary & Cremation. "Obituary for Lisa Hansen | Myers Mortuary & Cremation Services" (in en). https://www.myers-mortuary.com/obituary/Lisa-Hansen.
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66. ↑ "Tanzania mourns famed conjoined twins Maria and Consolata" (in en). 2021-04-12. https://www.thecitizen.co.tz/tanzania/news/national/tanzania-mourns-famed-conjoined-twins-maria-and-consolata-2639256.
67. ↑ "Alex Olson" (in en). 2018-04-02. https://www.plaintalk.net/obituaries/article_55e9b50a-36b8-11e8-aae9-93f73c0daec7.html.
68. ↑ (in en) Two Heads, One Body: The Remarkable Story of Conjoined Twins Katie & Eilish | Our Life, December 23, 2020, https://www.youtube.com/watch?v=SwzV-VdqbDo, retrieved 2022-12-03
69. ↑ Vencatareddy-Nursingen, Selvanee (2019-01-08). "Naissance de bébés siamois: émouvante rencontre entre les Papillon et les Fokeer" (in fr). https://www.lexpress.mu/article/345643/naissance-bebes-siamois-emouvante-rencontre-entre-papillon-et-fokeer.
70. ↑ "Siameses de Milagro arrancan una nueva etapa en su vida: estudiarán Trabajo Social tras obtener cupos universitarios" (in es). 2021-05-26. https://www.eluniverso.com/noticias/ecuador/siameses-de-milagro-arrancan-una-nueva-etapa-en-su-vida-estudiaran-trabajo-social-tras-obtener-cupos-universitarios-nota/.
71. ↑ "Conjoined Twins Refuse to Be Separated Despite Doctor's Warnings" (in en-US). PEOPLE.com. 2017-04-22. http://people.com/human-interest/conjoined-twins-refuse-separation-surgery/.
72. ↑ "Formerly conjoined twins celebrate 21st birthday". UCLA. August 2, 2022. https://www.uclahealth.org/news/article/formerly-conjoined-twins-celebrate-21st-birthday.
73. ↑ "Rosianne is zus van een Siamese tweeling: 'Als ze overlijden, word ik gek'". https://www.linda.nl/persoonlijk/siamese-tweeling-rosianne/.
74. ↑ "Formerly Conjoined Twins and Their Sister Enjoy Being 'Normal' Teenagers 17 Years After Surgery" (in en). https://people.com/human-interest/formerly-conjoined-twins-sister-enjoy-being-normal-teenagers/.
75. ↑ Staffenberg, David A.; Goodrich, James T. (January 2005). "Separation of craniopagus conjoined twins: an evolution in thought". Clinics in Plastic Surgery 32 (1): 25–34. doi:10.1016/j.cps.2004.09.002. PMID 15636762.
76. ↑ "Der Geburtstag der siamesischen Zwillinge Lea und Tabea jährt sich zum zweiten Mal" (in de). August 3, 2005. http://www.mennonews.de/archiv/2005/08/03/der-geburtstag-der-siamesischen-zwillinge-lea-und-tabea-jahrt-sich-zum-zweiten-mal/.
77. ↑ "Punjab Assembly Election 2022: Goggles On For Secrecy, Punjab's Conjoined Twins Cast Separate Votes". Ndtv.com. https://www.ndtv.com/india-news/punjab-assembly-election-2022-goggles-on-for-secrecy-punjabs-conjoined-twins-cast-separate-votes-2778383. Retrieved 2022-03-16.
78. ↑ "Miracle Girl - Washingtonian" (in en-US). 2007-11-01. https://www.washingtonian.com/2007/11/01/miracle-girl/.
79. ↑ "Formerly conjoined twins head home" (in en). 2004-07-02. http://www.nbcnews.com/health/health-news/formerly-conjoined-twins-head-home-flna1C9447038.
80. ↑ "Many-limbed India girl in surgery". BBC News. 2007-11-06. https://news.bbc.co.uk/1/hi/world/south_asia/7080326.stm.
81. ↑ Athanasiadis, Apostolos P.; Tzannatos, Christinne; Mikos, Themistoklis; Zafrakas, Menelaos; Bontis, John N. (June 2005). "A unique case of conjoined triplets". American Journal of Obstetrics and Gynecology 192 (6): 2084–2087. doi:10.1016/j.ajog.2004.10.622. PMID 15970906.
82. ↑ "Herrin Twins". http://www.herrintwins.com.
83. ↑ "Separating Twins". Pbs.org. February 8, 2012. https://www.pbs.org/wgbh/nova/video/separating-twins/.
84. ↑ Digitale, Erin (2011-11-02). "Conjoined twin toddlers successfully separated at Packard Children's" (in en-US). https://med.stanford.edu/news/all-news/2011/11/conjoined-twin-toddlers-successfully-separated-at-packard-childrens.html.
85. ↑ Philadelphia, The Children's Hospital of. "Conjoined Twins: Amelia and Allison’s Story | Children's Hospital of Philadelphia" (in en). https://www.chop.edu/stories/conjoined-twins-amelia-and-allison-s-story.
86. ↑ Cai, Wenjun (July 15, 2014). "Conjoined twins to be separated". http://www.shanghaidaily.com/metro/health-and-science/Conjoined-twins-to-be-separated/shdaily.shtml.
87. ↑ Wang, Hongyi (July 18, 2014). "Conjoined girls separated in surgery". http://www.chinadaily.com.cn/china/2014-07/18/content_17830845.htm.
88. ↑ "Mata conjoined twins successfully separated in complex, first-of-its-kind surgery at Texas Children's Hospital | Texas Children's" (in en). https://www.texaschildrens.org/content/news/mata-conjoined-twins-successfully-separated-complex-first-its-kind-surgery-texas.
89. ↑ "Formerly conjoined twins, 5, mark new milestone. See how they're doing now!" (in en). 2019-08-23. https://www.today.com/health/formerly-conjoined-mata-twins-are-now-5-start-pre-k-t161256.
90. ↑ Marcus, Mary Brophy (2016-03-29). "Conjoined Texas twins, Ximena and Scarlett Hernandez-Torres, get set for separation surgery - CBS News" (in en-US). https://www.cbsnews.com/news/conjoined-texas-twins-set-for-surgery/.
91. ↑ Howley, Christopher. "Formerly conjoined Texas sisters continue to beat the odds years after separation surgery" (in en-US). https://www.caller.com/story/news/2021/04/12/formerly-conjoined-texas-sisters-lead-healthy-lives-years-after-surgery/7160685002/.
92. ↑ Meghan Holohan (2016-10-14). "Formerly conjoined twins recovering, gaining mobility after separation". https://www.today.com/health/doctors-successfully-separate-twins-joined-skulls-t103979.
93. ↑ Meghan Holohan (2017-10-26). "Formerly conjoined twins are finally home 1 year after epic surgery". https://www.today.com/health/formerly-conjoined-twins-are-home-enjoying-life-toddlers-t117926.
94. ↑ Gupta, Wayne Drash,Dr Sanjay (2019-01-01). "For parents of separated twins, inspiration and heartache" (in en). https://www.cnn.com/2019/01/01/health/conjoined-twins-jadon-and-anias-update.
95. ↑ "Formerly conjoined twins, Erin and Abby Delaney, thriving months after separation surgery". October 22, 2017. https://www.chop.edu/news/formerly-conjoined-twins-erin-and-abby-delaney-thriving-months-after-separation-surgery.
96. ↑ "Formerly Conjoined Twins, 6, Graduate Kindergarten: ‘The Sky Is the Limit for Them’ Says Mom" (in en). https://people.com/formerly-conjoined-twins-graduate-kindergarten-7554070.
97. ↑ "A chance for a normal life | Texas Children's" (in en). https://www.texaschildrens.org/content/media/chance-normal-life.
98. ↑ Rees, Gwyneth (January 23, 2019). "Two girls, one body". BBC News. https://www.bbc.co.uk/news/resources/idt-sh/Wales_conjoined_twins.
99. ↑ "Conjoined twins given days to live are proving world wrong" (in en-GB). 2024-02-17. https://www.bbc.com/news/uk-wales-68145224.
100. ↑ "Conjoined twins in Blackfoot continue to beat the odds | The Spokesman-Review". January 24, 2018. https://www.spokesman.com/stories/2018/jan/24/conjoined-twins-in-blackfoot-continue-to-beat-the-/.
101. ↑ "A mom used to hide her conjoined twins. Now she shares their joy with the world" (in en). 2023-04-03. https://www.today.com/parents/family/chelsea-torres-shares-life-conjoined-twins-rcna77692.
102. ↑ "Second set of rare conjoined twins separated at Great Ormond Street Hospital in less than 12 months" (in en). https://www.gosh.nhs.uk/news/second-set-rare-conjoined-twins-separated-great-ormond-street-hospital-less-12-months.
103. ↑ "Separation of conjoined twins in London children's hospital 'a Moses moment'" (in en). June 12, 2020. https://www.thenationalnews.com/world/europe/separation-of-conjoined-twins-in-london-children-s-hospital-a-moses-moment-1.1032402.
104. ↑ Jack Guy; Sharon Braithwaite. "Twin girls, joined at the skull, successfully separated in Vatican hospital". https://www.cnn.com/2020/07/08/health/conjoined-twins-separated-vatican-scli-intl/index.html.
105. ↑ "Nigerian conjoined twins successfully separated by 78-member team in Abuja" (in en-US). CNN.com. January 8, 2020. https://www.cnn.com/2020/01/08/africa/nigerian-conjoined-twins-separated-intl/index.html.
106. ↑ "Inside the Successful Separation Surgery of Conjoined Twins" (in en). 2021-12-02. https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins.
107. ↑ Carpayen, Shelly (2019-11-17). "Séparée de sa soeur siamoise: Cléanne ou la joie de vivre" (in fr). https://www.lexpress.mu/article/365556/separee-sa-soeur-siamoise-cleanne-ou-joie-vivre.
108. ↑ "Marie-Cléanne Papillon : Le 3e bébé siamois miraculé au monde, selon son chirurgien". May 28, 2019. https://ionnews.mu/marie-cleanne-papillon-le-3e-bebe-siamois-miracule-au-monde-selon-son-chirurgien-28052019/.
109. ↑ "Jumelles siamoises: Marie-Cléa Papillon inhumée ce mardi" (in fr). 2019-03-26. https://www.lexpress.mu/article/349919/jumelles-siamoises-marie-clea-papillon-inhumee-ce-mardi.
110. ↑ "Separated conjoined twins doing well in Zagreb" (in en). 2019-05-15. https://www.croatiaweek.com/separated-conjoined-twins-doing-well-in-zagreb/.
111. ↑ Grizelj, Ruža; Sindičić Dessardo, Nada; Bulić, Krešimir; Luetić, Tomislav; Mikulić, Danko; Antabak, Anko; Sjekavica, Ivica; Alduk, Ana Marija et al. (August 2019). "Successful separation of xypho-omphalopagus conjoined twins with extrauterine twin-twin transfusion syndrome: a case report". Croatian Medical Journal 60 (4): 301–308. doi:10.3325/cmj.2019.60.301. ISSN 0353-9504. PMID 31483115.
112. ↑ Shamus, Kristen Jordan. "Rare conjoined twins, born locked in embrace, successfully separated in Michigan" (in en-US). https://www.freep.com/story/news/local/michigan/2020/09/18/conjoined-twins-michigan-sarabeth-amelia-irwin/5741856002/.
113. ↑ "Tiny twins with a big fight: Conjoined sisters survive separation" (in en-US). 2021-01-19. https://www.childrensmn.org/blog/tiny-twins-big-fight-conjoined-sisters-survive-separation/.
114. ↑ "Parents of formerly conjoined twins in Elk River search for help finding nurse" (in en-US). 2024-01-09. https://www.kare11.com/article/news/local/kare11-sunrise/parents-of-formerly-conjoined-twins-in-elk-river-search-for-help-finding-nurse/89-02bcbda8-c803-484f-85ad-689febaaaa60.
115. ↑ Hospital, Children's. "Rare set of conjoined twins successfully separated in 24-hour surgery at UC Davis Children's Hospital". https://health.ucdavis.edu/children/news/headlines/rare-set-of-conjoined-twins-successfully-separated-in-24-hour-surgery-at-uc-davis-childrens-hospital/2020/10.
116. ↑ Philadelphia, The Children's Hospital of. "The Story of Addy and Lily: Birth and Separation of Conjoined Twins | Children's Hospital of Philadelphia" (in en). https://www.chop.edu/stories/story-addy-and-lily-birth-and-separation-conjoined-twins.
117. ↑ Robinson, Carol (22 April 2023). "Alabama conjoined twin girls born at Philadelphia hospital: 'We love them so much'". AL.com. https://www.al.com/news/2021/04/alabama-conjoined-twin-girls-born-at-philadelphia-hospital-we-love-them-so-much.html.
118. ↑ "Texas Children's Hospital announces successful separation of conjoined twin brothers Lucas and Mateo | Texas Children's" (in en). 2023-07-17. https://www.texaschildrens.org/content/media/texas-childrens-hospital-announces-successful-separation-conjoined-twin-brothers.
119. ↑ "'Miracle' Conjoined Twins Born Fused at Chest 'Constantly Hug Each Other'" (in en). 2022-04-22. https://www.newsweek.com/conjoined-twins-born-fused-chest-annabelle-isabelle-bateson-1700049.
120. ↑ "Conjoined twins Annie and Issie return home for Christmas after separation surgery" (in en-GB). https://www.gosh.nhs.uk/news/conjoined-twins-annie-and-issie-return-home-for-christmas-after-separation-surgery/.
121. ↑ Gartner, Jordan (January 27, 2023). "Conjoined twin sisters separated in successful surgery: 'We did it'" (in en). https://www.kbtx.com/2023/01/27/conjoined-twin-sisters-separated-successful-surgery-we-did-it/.
122. ↑ "Formerly Conjoined Twins Celebrate 1st Birthday: 'They Are So Incredibly Strong,' Mom Says" (in en). https://people.com/formerly-conjoined-twins-ella-eliza-fuller-celebrate-1st-birthday-8610454.
123. ↑ "These formerly conjoined twins spent 134 days in the hospital in Texas. Now they're finally home. - CBS News" (in en-US). 2023-07-12. https://www.cbsnews.com/news/texas-conjoined-twins-ella-eliza-fuller/.
124. ↑ "Couple Who Welcomed Conjoined Twins Say They Cherished the Hour Their 'Beautiful' Girls Were Alive (Exclusive)" (in en). https://people.com/outpouring-of-support-after-georgia-couple-conjoined-twins-survived-an-hour-8690805.
125. ↑ Philadelphia, The Children's Hospital of. "Birth and Separation of Conjoined Twins: Amari and Javar’s Story | Children's Hospital of Philadelphia" (in en). https://www.chop.edu/stories/birth-separation-conjoined-twins-amari-javar.
126. ↑ Drabble, Emily (2016-06-20). "Sarah Crossan wins the Carnegie medal with verse novel One" (in en-GB). The Guardian. ISSN 0261-3077. https://www.theguardian.com/childrens-books-site/2016/jun/20/sarah-crossan-carnegie-medal-2016-one.

## External links

* Types and social history of conjoined twins
* The site of the medical Saudi team responsible for numerous successful separation surgeries
* Eng and Chang – The Original Siamese Twins; The University of North Carolina at Chapel Hill, The North Carolina Collection Gallery
* The Human Marvels: A Historical Reference Site run by J. Tithonus Pednaud, Teratological Historian
* Cases of conjoined and incomplete twins
* Clara and Alta Rodriguez, joined at the pelvis and successfully separated in 1974 at Children's Hospital of Philadelphia by surgeons including C. Everett Koop
* National Library of Medicine: Selected Moments in the History of Conjoined Twins
* Conjoined Twins Fast Facts (also lists additional twins)
* Emedicine article (this article includes post-mortem images)
* Facts About Multiples: Conjoined Records and stats
* "The St. Benoit Twins", Scientific American, July 13, 1878, p. 24

Classification|

* ICD-10: O33.7, Q89.4
* ICD-9-CM: 678.1, 759.4
* MeSH: D014428
* DiseasesDB: 34474

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External resources|

* eMedicine: ped/2936

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