AIIMS doctors remove 15-kg 'parasitic twin' from UP teen in rare surgery

According to medical experts, as patients age, these parasitic growths can lead to cardiovascular and neurological complications, posing life-threatening risks.

In a rare and complex surgical procedure, doctors at the All India Institute of Medical Sciences (AIIMS) in Delhi successfully removed a 15 kg “parasitic twin” from a 17-year-old boy hailing from Uttar Pradesh’s Unnao district.

The extremely rare form of conjoined twinning had caused significant physical and emotional distress to the teenager.

The boy living with the rare condition since birth carried additional lower limbs and external genitalia on his abdomen. Despite experiencing sensations like touch, pain, and temperature in the parasitic limb, he mostly led a normal life, apart from occasional abdominal discomfort.
The condition also forced him to drop out of school at the age of eight. Social isolation and medical warnings about potential fatality prevented any prior intervention.

Conjoined twins occur in about 1 in 50,000 to 100,000 births, but cases of asymmetrical or “parasitic” twinning are far rarer, with only 40 documented instances in the medical literature. In such cases, one twin (autosite) develops fully, while the other (parasite) remains dependent and underdeveloped.

According to medical experts, as patients age, these parasitic growths can lead to cardiovascular and neurological complications, posing life-threatening risks.

After a relative advised treatment at AIIMS, the boy arrived at the hospital's outpatient department on January 28. Initially, doctors mistook his covered abdomen for a carried child, but further examination revealed two fully developed lower limbs with external genitalia attached to his abdomen.

According to a Times of India report, the multidisciplinary team, including surgeons, radiologists, and anesthesiologists, evaluated his condition.

CT angiography revealed that the parasitic limb's blood supply originated from an internal mammary artery branch, while scans also identified a large abdominal cystic mass. Due to the patient’s socio-economic background, early prenatal detection of his condition could not be possible.

After extensive preoperative planning, surgery was scheduled for February 8, 2025. The procedure was performed in two phases: first, the removal of the parasitic limb through careful dissection and vessel ligation followed by the excision of the abdominal cystic mass.
Surgeons also found and removed underdeveloped testes within the attachment site.

The second phase required precise separation of the cystic mass from surrounding organs, particularly an abnormally extended bladder. The operation lasted approximately 2 to 2.5 hours.

The surgery was successful, with no additional health complications. The boy resumed oral feeding the next day, had his drain removed on the third day, and was discharged on the fourth day. Initially experiencing phantom sensations, he is now looking forward to a normal life after 17 years of physical and emotional challenges.

The groundbreaking surgery was performed by a team of specialists, including Dr. Asuri Krishna, Dr. VK Bansal, Dr. Sushant Soren, Dr. Brijesh Kumar Singh, Dr. Abhinav Kumar, and Dr. Jaymeen Makwana from Surgical Disciplines; Dr. Manish Singhal and Dr. Sashank from Plastic Surgery; Dr. Ganga Prasad and Dr. Rakesh from Anaesthesia; and Dr. Atin and Dr. Ankita from Radiology.