Successful Separation of Female Omphalopagus Conjoined Twins at the Mother and Child University Hospital Center in N'Djamena, Chad: A Case Report.

BACKGROUND Conjoined twin pregnancies are rare, and the twins can be connected via shared organs or anatomical structures. Omphalopagus conjoined twins represent 10% of cases and are connected at the abdominal wall, typically between the xiphoid process and the umbilicus. They can share the liver, biliary tract, and upper gastrointestinal system. This report describes the successful separation of female omphalopagus conjoined twins at a specialist center in N'Djamena, Chad. CASE REPORT One-day-old female omphalopagus conjoined twins were admitted to the Mother and Child University Hospital in N'Djamena. The mother had received no prenatal consultations, and delivery occurred at home via the vaginal route. Evaluation by abdominal computed tomography revealed fusion at the abdominal wall and a shared liver. The heart and other vital organs were separate. A successful elective surgical separation was performed by a multidisciplinary team. The twins had a favorable postoperative course and were discharged on day 25. At 24-month follow-up, they show good psychomotor development despite a transient episode of malnutrition. CONCLUSIONS Successful separation confirms the favorable prognosis of omphalopagus twins, especially when preoperative imaging demonstrates distinct vital organs. Achieving this surgical outcome in a low-resource setting highlights the critical role of a rigorous multidisciplinary approach to the diagnosis, evaluation, and management of conjoined twins and the importance of careful follow-up after twin separation.