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This case report describes the management of Xipho-omphalopagus conjoint twins in North central Nigeria. Conjoint twins have been reported in literature and they present very enigmatic and grotesque appearances. The aim of management of most cases is to separate them into two independent persons, but in case of parasitic twins, is to remove the parasite from the autosite. On the 11th of June 2018, a set of conjoint twins were referred to the Paediatric Surgery Division of our Hospital. The patients were delivered by a caesarian section after a prolonged labour at St Mary’s Hospital in Gwagwalada. Two operation teams were constituted which undertook six sessions of conference discussions and several drills on how to mobilize, position, transport, intubate and monitor these patients through the course of operation and in the post-operative care. The management of conjoint twins is multidisciplinary and requires that the managing team, the parents and community have a common understanding with a view of the successful separation of the babies. The society is very limited in the knowledge of the requirements for care, yet put so much pressure on the doctors and the health care institutions to deliver on the separation of conjoint twins, it would be appropriate as was done in this case to constitute a media team of the hospital to respond to concerns from media houses and interested parties so as to allow the managing team concentrate on their professional duties.
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