What if a Conjoined Twin Dies?

The death of one conjoined twin immediately necessitates an emergency surgical separation to protect the life of the surviving twin. This is a critical medical emergency requiring swift action.

Immediate Action: Emergency Separation

When one conjoined twin passes away, their deceased body poses a severe and immediate threat to the surviving sibling due to their shared physiological systems. This unique situation calls for urgent surgical intervention to prevent further complications and to save the life of the living twin.

Why Emergency Separation is Crucial

The primary reason for performing an immediate surgical separation is to mitigate the life-threatening risks that the deceased twin presents to the healthy twin. The shared biological connections mean that the death of one twin can rapidly lead to the demise of the other.

Here are the critical risks involved:

• Overwhelming Sepsis: The decaying tissues of the deceased twin can release toxins and bacteria directly into the shared bloodstream. This can lead to overwhelming sepsis, a severe, body-wide infection that can quickly become fatal for the surviving twin.
• Shared Organ Failure: If vital organs are shared between the twins, the failure of these organs in the deceased twin will directly compromise the function of the same organs in the surviving twin. This can lead to cascade organ failure in the living twin, as their body struggles to compensate for the shared, non-functioning organ system.
• Metabolic Instability: The metabolic byproducts and waste products from the deceased twin's body can accumulate in the shared circulation, leading to severe chemical imbalances and organ damage in the living twin.

The Goal of Separation

The ultimate goal of an emergency separation procedure is to isolate the healthy twin from the profound dangers posed by their deceased sibling. While such surgeries are incredibly complex and carry significant risks, they are performed with the intent of saving the life of the surviving conjoined twin. There have been instances where successful separations have been achieved even when one twin was stillborn, demonstrating the potential for positive outcomes in these dire circumstances.