View source for Conjoined twins

{{Redirect|Siamese twins}}
{{Use mdy dates|date=June 2022}}
{{Infobox medical condition (new)
| name            = Conjoined twins
| synonyms        = Siamese twin
| image           = Conjoined X-ray.jpg
| caption         = X-ray of conjoined twins, Cephalothoracopagus.
| symptoms        = Bodies fused
| complications   = Depends on type
| onset           = Beginning of pregnancy
| duration        = Lifelong
| types           = See article
| causes          = Incomplete fission
| risks           = 
| diagnosis       = 
| differential    = 
| prevention      = 
| treatment       = [[Surgery]], [[symptomatic care]]
| medication      = 
| prognosis       = Depends on type; occasionally may survive
| frequency       = 
| deaths          = 
}}
[[File:Conjoined twins, War Remnants Museum シャム双生児 S0010001.jpg|thumb|260px|right|Conjoined twins ([[War Remnants Museum]])]]
'''Conjoined twins''', popularly referred to as '''Siamese twins''',<ref>{{cite web|title=conjoined twin|url=https://www.britannica.com/science/conjoined-twin|access-date=2021-11-05|website=Encyclopedia Britannica|language=en}}</ref><ref>{{cite web|title=Medical Definition of Conjoined twin|url=https://www.medicinenet.com/conjoined_twin/definition.htm|access-date=2021-11-05|website=MedicineNet|language=en}}</ref> are [[twin]]s joined ''[[Uterus|in utero]]''.{{Efn|Conjoined twins are almost universally assumed to always be [[monozygotic]], but [[dizygotic]] conjoined twins are theoretically possible.<ref>{{Cite journal |title=Diagnosis of conjoined twins before 16 weeks' gestation: The 4-year experience of one medical center |journal=Prenatal Diagnosis |url=https://cris.tau.ac.il/en/publications/diagnosis-of-conjoined-twins-before-16-weeks-gestation-the-4-year |last1=Maymon |first1=Ron |date= September 2005|volume=25 |pages=839–843 |last2=Mendelovic |first2=Sonia |issue=9 |last3=Schachter |first3=Morey |last4=Ron-El |first4=Raphael |last5=Weinraub |first5=Zwi |last6=Herman |first6=Arie|doi=10.1002/pd.1274 |pmid=16170850 |s2cid=32204640 |url-access=subscription }}</ref><ref>{{Cite journal |title=Potential risk of monochorionic dizygotic twin blastocyst formation associated with early laser zona dissection of group cultured embryos |journal=Fertility and Sterility |url=https://www.fertstert.org/article/S0015-0282(14)02355-3/fulltext |last1=Schiewe |first1=Mitchel C. |date=February 1, 2015 |volume=103 |pages=417–421 |last2=Whitney |first2=John B. |issue=2 |quote=one could predict dizygotic conjoined twins occurring less than 1 in every 4.7 billion ovulation cycles |last3=Anderson |first3=Robert E.|doi=10.1016/j.fertnstert.2014.11.009 |pmid=25516079 |doi-access=free }}</ref>}} 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.<ref name="Carnevale et al 2006">{{cite journal |last1=Carnevale |first1=Francisco Cesar |last2=Borges |first2=Marcus Vinicius |last3=Affonso |first3=Breno Boueri |last4=Pinto |first4=Ricardo Augusto de Paula |last5=Tannuri |first5=Uenis |last6=Maksoud |first6=João Gilberto |title=Importance of angiographic study in preoperative planning of conjoined twins: case report |journal=Clinics |date=April 2006 |volume=61 |issue=2 |pages=167–70 |doi=10.1590/S1807-59322006000200013 |pmid=16680335 |doi-access=free }}</ref> Approximately half are [[stillbirth|stillborn]], and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1.<ref name="Carnevale et al 2006"/><ref name=kmedscape>{{EMedicine|article|934680|Conjoined Twins}}</ref>

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.<ref name=embryology>{{cite journal |last1=Kaufman |first1=M.H. |title=The embryology of conjoined twins |journal=Child's Nervous System |date=August 2004 |volume=20 |issue=8–9 |pages=508–25 |doi=10.1007/s00381-004-0985-4 |pmid=15278382 |s2cid=206964928 }}</ref> The other explanation, no longer believed to be accurate,<ref name=embryology/> is ''fusion'', in which the fertilized egg completely separates, but [[stem cell]]s (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]]''.<ref>{{cite book |author1=Tao Le |last2=Bhushan |first2=Vikas |last3=Vasan |first3=Neil |year=2010 |title=First Aid for the USMLE Step 1: 2010 20th Anniversary Edition |publisher=[[The McGraw-Hill Companies, Inc.]] |location=USA |isbn=978-0-07-163340-6 |page=121 |url=https://archive.org/details/firstaidforusmle0000unse_r6p4/page/121}}</ref>

[[Chang and Eng Bunker]] (1811–1874) were brothers born in [[Rattanakosin Kingdom (1782–1932)|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.<ref>{{cite web|url=https://www.bbc.co.uk/dna/h2g2/alabaster/A369434 |archive-url=https://web.archive.org/web/20020211193648/http://www.bbc.co.uk/dna/h2g2/alabaster/A369434 |url-status=dead |archive-date=February 11, 2002 |title=h2g2 – Twins – A369434 |publisher=Bbc.co.uk |access-date=2014-08-03}}</ref> Due to the brothers' fame and the rarity of the condition, the term ''Siamese twins'' came to be associated with conjoined twins.

== Causes ==
There are two hypotheses about the development of conjoined twins.
# 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.<ref>{{cite book |title=DC Dutta's textbook of obstetrics |isbn=9789351527237 |page=233 |edition=Eighth|last1=Konar |first1=Hiralal |date=May 10, 2015 |publisher=JP Medical }}</ref>
# fusion of two fertilized eggs occurs early in development.

Partial splitting of the [[primitive node]] and [[Primitive streak|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 [[Homeobox protein goosecoid |goosecoid]], may also result in conjoined twins.<ref>{{cite book |title=Langman's medical embryology |isbn=9781496383907 |page=124 |edition= 14th |last1=Sadler |first1=Thomas W. |date=October 29, 2018 |publisher=Wolters Kluwer }}</ref> 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.<ref>{{cite book |title=Langman's medical embryology |isbn=9781496383907 |page=63 |edition= 14th |last1=Sadler |first1=Thomas W. |date=October 29, 2018 |publisher=Wolters Kluwer }}</ref>

== {{anchor|Types of conjoined twin}}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):<ref name=embryology/> 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]].<ref name="duplicata">{{cite web|url=http://www.thefetus.net/page.php?id=1494|date=March 1, 2006|archive-url=https://web.archive.org/web/20090819191053/http://www.thefetus.net/page.php?id=1494|archive-date=August 19, 2009|title=Duplicata incompleta, dicephalus dipus dibrachius|first=Yuliya|last=Burmagina|website=TheFetus.net}}</ref> Survival rate is poor.<ref name=":1">{{Cite web |title=Conjoined Twins: Definition, Causes & Outlook |url=https://my.clevelandclinic.org/health/diseases/22895-conjoined-twins |access-date=2023-12-15 |website=Cleveland Clinic |language=en}}</ref>
* ''Thoraco-omphalopagus'' (18.5%):<ref name=embryology/> Two bodies fused from the upper chest to lower belly. The heart is always shared in these cases.<ref name=duplicata/> {{As of|2015}}, 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%):<ref name=embryology/> 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 (anatomy)|diaphragm]] and other organs.<ref name=duplicata/> Survival rate is 82%.<ref name=":1" />
* ''Heteropagus''<ref>{{Cite journal |last1=Sharma |first1=Gaurav |last2=Mobin |first2=Sheila S. Nazarian |last3=Lypka |first3=Michael |last4=Urata |first4=Mark |date=December 2010 |title=Heteropagus (parasitic) twins: a review |journal=Journal of Pediatric Surgery |volume=45 |issue=12 |pages=2454–2463 |doi=10.1016/j.jpedsurg.2010.07.002 |issn=1531-5037 |pmid=21129567}}</ref> ([[parasitic twin]]) (10%):<ref name=embryology/> 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 twins|Craniopagus]]'' (6%):<ref name=embryology/> Fused [[human skull|skull]]s, 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.<ref name=duplicata/> Survival rate is poor.<ref name=":1" />

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 (mythology)|Janus]]).<ref name=duplicata/>
* ''Syncephalus'': One head with a single face but four ears and two bodies.<ref name=duplicata/>
* ''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.<ref name=duplicata/><ref>{{cite web |url=http://www.collphyphil.org/virt_tour/museum_8.htm |title=Cephalothoracopagus Menosymmetro (Conjoined Twins) |website=collphyphil.org| publisher= Mütter Museum, The College of Physicians of Philadelphia |access-date=2014-08-03 |url-status=dead |archive-url= https://web.archive.org/web/20100815054642/http://www.collphyphil.org/virt_tour/museum_8.htm |archive-date=2010-08-15 }}</ref>
* ''Xiphopagus'': Two bodies fused in the [[Xiphoid process|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.<ref name=duplicata/> A famous example is [[Chang and Eng Bunker]].
* ''[[Ischiopagi|Ischiopagus]]'': Fused lower half of the two bodies, with [[Vertebral column|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 [[Human anus|anus]].<ref name=duplicata/> Survival rate is 63%.<ref name=":1" />
* ''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.<ref name=duplicata/>
* ''Parapagus'': Fused side by side with a shared [[human pelvis|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.<ref name=duplicata/> Survival rate is poor.<ref name=":1" />
* ''[[Craniopagus parasiticus]]'': Like craniopagus, but with a second bodiless head attached to the dominant head.
* ''Pygopagus'' or ''Iliopagus'': Two bodies joined at the pelvis.<ref name=duplicata/> Survival rate is 68%.<ref name=":1" />
* ''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.<ref>{{cite journal |last1=Spencer |first1=Rowena |title=Rachipagus conjoined twins: They really do occur! |journal=Teratology |date=December 1995 |volume=52 |issue=6 |pages=346–356 |doi=10.1002/tera.1420520605 |pmid=8711621 }}</ref> Twins of this type cannot be separated.<ref name=":1" />
* ''Tricephalus'' (conjoined triplets): Extremely rare conjoining of 3 fetuses. Very few confirmed cases, both human and animal, are known.<ref>{{Cite journal |last1=Oostra |first1=Roelof-Jan |last2=Schepens-Franke |first2=Annelieke N. |last3=Magno |first3=Giovanni |last4=Zanatta |first4=Alberto |last5=Boer |first5=Lucas L. |date=2022-07-15 |title=Conjoined twins and conjoined triplets: At the heart of the matter |journal=Birth Defects Research |language=en |volume=114 |issue=12 |pages=596–610 |doi=10.1002/bdr2.2066 |pmid=35766259 |pmc=9546242 |s2cid=250114880 |issn=2472-1727|doi-access=free }}</ref>

==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.<ref>{{Cite journal |last1=Fallon |first1=Sara C. |last2=Olutoye |first2=Oluyinka O. |date=2018-10-01 |title=The surgical principles of conjoined twin separation |url=https://www.sciencedirect.com/science/article/pii/S0146000518300521 |journal=Seminars in Perinatology |series=Conjoined Twins |volume=42 |issue=6 |pages=386–392 |doi=10.1053/j.semperi.2018.07.013 |pmid=30477661 |s2cid=53767929 |issn=0146-0005|url-access=subscription }}</ref> 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.<ref>{{cite book |title=One of Us: Conjoined Twins and the Future of Normal |url=https://archive.org/details/oneofus00alic |url-access=registration |first=Alice Domurat |last=Dreger |isbn=978-0-674-01825-9 |publisher=Harvard University Press |date=2004 }}</ref> [[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.<ref>{{cite web |url=http://www.medievalists.net/2014/01/the-case-of-conjoined-twins-in-10th-century-byzantium/ |title=The Case of Conjoined Twins in 10th Century Byzantium |website=Medievalists.net |date=January 4, 2014}}</ref><ref>{{cite journal |url=http://denysmontandon.com/wp-content/uploads/2016/01/conjoined-twins.pdf |archive-url=https://web.archive.org/web/20170225215336/http://denysmontandon.com/wp-content/uploads/2016/01/conjoined-twins.pdf |archive-date=2017-02-25 |url-status=live |title=The unspeakable history of Thoracopagus twins' separation |first=Denys |last=Montandon |journal=ISAPS News |volume=9 |number=3 |year=2015 |pages=47–48}}</ref> The first recorded successful separation of conjoined twins was performed in 1689 by [[Johannes Fatio]].<ref>{{cite journal |last1=Kompanje |first1=Erwin J. O. |title=The First Successful Separation of Conjoined Twins in 1689: Some Additions and Corrections |journal=Twin Research |date=December 1, 2004 |volume=7 |issue=6 |pages=537–541 |doi=10.1375/1369052042663760 |pmid=15607002 |doi-access=free }}</ref> 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.<ref>{{Cite book |last1=Hirst |first1=Barton Cooke |url=http://archive.org/details/humanmonstrosities04hirs |title=Human monstrosities |last2=Piersol |first2=George A. (George Arthur) |date=1891 |publisher=Philadelphia, Lea brothers & co. |others=University of Connecticut Libraries and Hartford Medical Society Historical Library}}</ref> In 1955, neurosurgeon Harold Voris (1902-1980)<ref>{{cite web |url=http://photoarchive.lib.uchicago.edu/db.xqy?one=apf1-08520.xml |title=Voris, Harold C. |publisher=The University of Chicago Photographic Archive |date=1972 |access-date=2017-07-30}}</ref> and his team at [[Mercy Hospital and Medical Center|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.<ref>{{cite journal |last1=Stone |first1=James L. |last2=Goodrich |first2=James T. | author2-link=James T. Goodrich |title=The craniopagus malformation: classification and implications for surgical separation |journal=Brain |date=May 1, 2006 |volume=129 |issue=5 |pages=1084–1095 |doi=10.1093/brain/awl065 |pmid=16597654 |doi-access=free }}</ref><ref>{{cite web |url=https://www.mercy-chicago.org/mercy-firsts |title=Mercy Care Firsts |website=Mercy Hospital & Medical Center Chicago |access-date=October 14, 2015 |archive-date=May 29, 2019 |archive-url=https://web.archive.org/web/20190529185116/https://www.mercy-chicago.org/mercy-firsts |url-status=dead }}</ref><ref>{{cite news |title=Separate Siamese Twins! |url=http://archives.chicagotribune.com/1955/04/22/page/1/article/separate-siamese-twins |date=April 22, 1955 |access-date=October 14, 2015 |newspaper=[[Chicago Tribune]]}}</ref> The larger girl was reported in 1963 as developing normally, but the smaller girl was permanently impaired.<ref>{{cite journal |last1=Voris |first1=Harold C. |title=Cranioplasty in a Craniopagus Twin |journal=Journal of Neurosurgery |date=February 1963 |volume=20 |issue=2 |pages=145–147 |doi=10.3171/jns.1963.20.2.0145 |pmid=14192083 |s2cid=37985174 |s2cid-access=free|doi-access= }}</ref>

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.<ref>{{cite web |url=http://www4.vindy.com/extra/tributes/905419781.html |title=Dr. Bewrtram Katz, 83 – Obituary |website=Vindy.com |access-date=2014-08-03 |archive-url=https://web.archive.org/web/20131110222735/http://www4.vindy.com/extra/tributes/905419781.html |archive-date=2013-11-10 |url-status=dead }}</ref> 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.<ref>[http://www.twinstuff.com/component/content/article/26-twin-facts/119-conjoined-twins-1950s?directory=27 <!-- accessed April 11, 2013 -->]{{dead link|date=June 2016|bot=medic}}{{cbignore|bot=medic}}</ref>

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.<ref>{{cite news |url=http://www.channelnewsasia.com/cna/analysis_prog/incon/incon_doc2.htm |work=Channel News Asia Singapore |title=In Conversation with Medicine's Miracle Workers – Dr Chumpon Chan and Dr Keith Goh |date=April 19, 2001 |access-date=March 27, 2010 |url-status=dead |archive-url=https://web.archive.org/web/20110114212842/http://www.channelnewsasia.com/cna/analysis_prog/incon/incon_doc2.htm |archive-date=January 14, 2011}}</ref> 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.<ref>{{cite web |url=http://www.monstersandcritics.com/news/southasia/news/article_1420406.php/Nepali_twin_dies_7_years_after_97-hour_separation_surgery |title=Nepali twin dies 7 years after 97-hour separation surgery |website=Monsters and Critics |date=July 30, 2008 |archive-url=https://web.archive.org/web/20081101095900/http://www.monstersandcritics.com/news/southasia/news/article_1420406.php/Nepali_twin_dies_7_years_after_97-hour_separation_surgery |archive-date=2008-11-01}}</ref>

Infants Rose and Grace Attard, conjoined twins from Malta, were separated in the United Kingdom by court order ''[[Re A (conjoined twins)|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 [[Saint Mary's Hospital, Manchester|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.<ref>{{cite news |url=https://news.bbc.co.uk/2/hi/health/1292681.stm |work=BBC News |title=Siamese twin Jodie "to go home soon" |date=April 23, 2001 |access-date=March 27, 2010}}</ref><ref>{{cite journal |last1=Appel |first1=Jacob M. |title=Ethics: English High Court Orders Separation of Conjoined Twins |journal=The Journal of Law, Medicine & Ethics |date=September 2000 |volume=28 |issue=3 |pages=312–313 |doi=10.1111/j.1748-720x.2000.tb00678.x |pmid=11210387 |s2cid=36191724 }}</ref> Grace survived to enjoy a normal childhood.<ref>{{cite news |url=http://www.thefreelibrary.com/We+don%27t+know+how+to+tell+Gracie+her+sister+died+so+she+could+live%3B...-a0166174616 |title=We don't know how to tell Gracie her sister died so she could live |via=Free Online Library |date=July 9, 2007 |work=The Mirror |access-date=2014-08-03}}</ref>

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.<ref>{{cite magazine |url=https://www.wired.com/wired/archive/11.10/twins_pr.html |title=Wired 11.10: Till Death Do Us Part |magazine=Wired |date=2001-04-11 |access-date=2014-08-03}}</ref> 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.<ref>{{cite web | title=Conjoined twins return home after successful separation | date=October 19, 2020 | url=https://www.bbc.com/news/health-54385415 }}</ref><ref>{{cite web |url=https://www.bbc.co.uk/news/extra/PLNMqvmycN/conjoined-twins |title=The battle to separate Safa and Marwa |website=BBC News |access-date=2019-07-18}}</ref><ref>{{cite web |url=https://www.gosh.nhs.uk/news/separating-conjoined-twins |archive-url=https://web.archive.org/web/20190717081048/https://www.gosh.nhs.uk/news/separating-conjoined-twins |url-status=dead |archive-date=July 17, 2019 |title=Separating conjoined twins |website=www.gosh.nhs.uk |language=en |access-date=2019-07-18}}</ref>

== History ==
[[Image:Nuremberg chronicles - Male Siamese twins (CCXVIIr).jpg|thumb|left|Conjoined brothers from ''[[Nuremberg Chronicle]]'' (1493)]]
[[Image:Nuremberg chronicles - Female Siamese Twins (CLXXXIIv).jpg|thumb|left|Conjoined twin sisters from ''Nuremberg Chronicle'' (1493)]]
[[Image:Conjoinedtwinslarcomuseum.jpg|thumb|[[Moche culture|Moche]] ceramics depicting conjoined twins. 300 AD [[Larco Museum|Larco Museum Collection]] Lima, Peru]]
The [[Moche (culture)|Moche]] culture of ancient Peru depicted conjoined twins in their ceramics dating back to 300 AD.<ref>Berrin, Katherine & Larco Museum. ''The Spirit of Ancient Peru:Treasures from the [[Larco Museum|Museo Arqueológico Rafael Larco Herrera]].'' New York: [[Thames and Hudson]], 1997.</ref> Writing around 415 AD, [[Augustine of Hippo|St. Augustine of Hippo]], in his book, ''[[City of God (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."<ref>{{cite web|url=http://www.newadvent.org/fathers/120116.htm |title=CHURCH FATHERS: City of God, Book XVI (St. Augustine) |publisher=Newadvent.org |access-date=2014-08-03}}</ref>

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 (region)|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."<ref>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.</ref>

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).<ref name="pg69">The Life of the Prophet Muhammad: Al-Sira Al-Nabawiyya By Ibn Kathir, Trevor Le Gassick, Muneer Fareed, pg. 132</ref> The Muslim [[polymath]] [[Abū al-Rayhān al-Bīrūnī]] described conjoined twins in his book ''Kitab-al-Saidana''.<ref name="Zahoor">A. Zahoor (1997), [http://www.unhas.ac.id/rhiza/arsip/saintis/biruni.html Abu Raihan Muhammad al-Biruni] {{Webarchive|url=https://web.archive.org/web/20200225113805/http://www.unhas.ac.id/rhiza/arsip/saintis/biruni.html |date=February 25, 2020 }}, [[Hasanuddin University|Hasanuddin U]]</ref>

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 [[Ilona and Judit Gófitz|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.

[[Image:Bunker Grave.jpg|right|thumb|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 Bunker|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|Giacomo and Giovanni Tocci]], from [[Locana]], Italy, were immortalized in [[Mark Twain]]'s short story "Those Extraordinary Twins" as fictitious twins Angelo and Luigi. The Toccis, born in 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. They are believed to have died around this time, though some sources claim they survived until 1940, living in seclusion in Italy.
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==Notable people==
===Born 19th century and earlier===
[[File:ChangandEng.jpg|thumb|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.<ref name=JB1992>{{citation|last=Bondeson|first=Jan|author-link=Jan Bondeson|date=April 1992|title=The Biddenden Maids: a curious chapter in the history of conjoined twins|journal=Journal of the Royal Society of Medicine|publisher=Royal Society of Medicine Press|location=London|volume=85|issue=4|pages=217–221|doi=10.1177/014107689208500413 |pmc=1294728|pmid=1433064}}</ref> They are the earliest set of conjoined twins whose names are (purportedly) known.
*[[Lazarus and Joannes Baptista Colloredo]] (1617 – after 1646), [[Parasitic twin|autosite-and-parasite]] pair
*[[Helen and Judith of Szony]] (Hungary, 1701–1723), [[pygopagus]].
*[[Chang and Eng Bunker]] (1811–1874). The Bunker twins were born of Chinese origin in [[Rattanakosin Kingdom|Siam]] (now Thailand), and the expression ''Siamese twins'' is derived from their case. They were joined by the areas around their [[xiphoid process|xiphoid cartilage]]s, 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.<ref>{{Cite web |title=Digital Collections - National Library of Medicine |url=https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-57221200R-bk#page/278/mode/2up/search/supernumerary+limbs |access-date=2022-09-22 |website=collections.nlm.nih.gov}}</ref>
*[[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),<ref>{{Cite book|last=Hartzman|first=Marc|title=American Sideshow: An Encyclopedia of History's Most Wondrous and Curiously Stranger Performers|publisher=Jeremy P. Tarcher / Penguin|year=2005|isbn=978-1585425303|location=New York, NY|pages=20–21|language=English}}</ref> [[pygopagus]].<ref name=":0">{{Cite journal|date=1891-10-01|title=The Double Monster Rosa-Josepha Blazek|url=https://www.journals.uchicago.edu/doi/10.1086/275418|journal=The American Naturalist|volume=25|issue=298|pages=891–894|doi=10.1086/275418|bibcode=1891ANat...25..891. |s2cid=222330134|issn=0003-0147|url-access=subscription}}</ref> The Blazek twins were born in Skrejšov, Bohemia (now the Czech Republic).<ref name=":0" /> 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.<ref>{{Cite journal|last=Breakstone|first=Benjamin H.|date=August 1922|title=The Last Illiness of the Blazek Grown-Together Twins|url=https://books.google.com/books?id=n3I4AQAAMAAJ|journal=Illinois Medical Journal|volume=42|pages=123–130|via=Google Books}}</ref>

===Born 20th century===
*[[Daisy and Violet Hilton]] of [[Brighton, East Sussex|Brighton]], England (1908–1969), [[#Types|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.<ref>{{Cite book|last=Miller|first=Sarah|title=Violet and Daisy: The Story of Vaudeville's Famous Conjoined Twins|publisher=Schwartz & Wade Books|year=2021|isbn=978-0593119723|location=New York|page=221|language=English}}</ref> They also appeared in the movies ''[[Freaks (1932 film)|Freaks]]'' and ''[[Chained for Life (1952 film)|Chained for Life]]''.
*[[Lucio and Simplicio Godina]] of Samar, Philippines (1908–1936)
*Mary and Margaret Gibb of [[Holyoke, Massachusetts]] (1912–1967)<ref name="hartzman">{{cite book |last1=Hartzman |first1=Marc |title=American Sideshow |date=2006 |publisher=Penguin Publishing Group |location=East Rutherford |isbn=1585425303 |pages=159–160}}</ref>
*[[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), [[#Types|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<ref>{{Cite web |date=2019-08-05 |title=Succesvol scheiden van een Siamese tweeling: het lukte in 1954 bij de Nederlandse Tjitske en Folkje |url=https://eenvandaag.avrotros.nl/item/succesvol-scheiden-van-een-siamese-tweeling-het-lukte-in-1954-bij-de-nederlandse-tjitske-en-folkje/ |access-date=2024-09-18 |website=EenVandaag |language=nl}}</ref>
*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.<ref>{{Cite news|url=https://www.vanguardngr.com/2015/12/wariboko-oki-62-nigerias-celebrated-siamese-twin-tells-her-life-story/|title=WARIBOKO OKI @ 62: Nigeria's celebrated Siamese twin tells her life story|date=2015-12-12|work=Vanguard News|access-date=2018-09-02|language=en-US}}</ref>
*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.<ref>{{Cite web |last=communications |date=2023-09-06 |title=Alumni Spotlight: MVSU Alums, who were Born Conjoined Twins Share their Story of Life, Love and Survival |url=https://www.mvsu.edu/alumni-spotlight-mvsu-alums-who-were-born-conjoined-twins-share-their-story-life-love-and-survival |access-date=2025-07-28 |website=Mississippi Valley State University |language=en}}</ref><ref>{{Cite web |date=2023-03-03 |title=Successfully separated conjoined twins share life story 67 years later |url=https://www.today.com/parents/family/separated-conjoined-twins-share-life-story-rcna73230 |access-date=2025-07-28 |website=TODAY.com |language=en}}</ref>
*[[Lori and George Schappell]] of [[Reading, Pennsylvania]] (1961–2024), American entertainers, [[#Types|craniopagus]]. At the time of their death, they were the world's oldest living conjoined twins.<ref>{{cite web | url        = https://www.oldest.org/people/living-conjoined-twins/ | title      = 6 Oldest Living Conjoined Twins in the World | date = September 5, 2019 | accessdate = June 21, 2022}}</ref> ''[[Guinness World Records]]'' noted that George's [[gender transition]] made him and Lori the first same-sex conjoined twins to identify as different genders.<ref>{{cite web |title=First same-sex conjoined twins to identify as different genders |url=https://www.guinnessworldrecords.com/world-records/384329-first-conjoined-twins-to-identify-as-mixed-gender |website=[[Guinness World Records]] |access-date=11 March 2023}}</ref>
*[[Spider Girls|Ganga and Jamuna Mondal]] of India, born 1969 or 1970, known professionally as The Spider Girls and The Spider Sisters. [[#Types|Ischiopagus]].
*Anna and Barbara Rozycki (born 1970), the first conjoined twins successfully separated in the UK.<ref>{{Cite news |date=2023-07-05 |title=UK's first separated conjoined twins forever grateful to NHS |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-england-coventry-warwickshire-66103970 |access-date=2023-07-10}}</ref>
*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.<ref>{{Cite news |title=Utah Doctors Separate Siamese Twins Linked at Brain |url=https://www.nytimes.com/1979/05/31/archives/utah-doctors-separate-siamese-twins-linked-at-brain.html |date=1979-05-31 |work=[[The New York Times]] |language=en}}</ref> 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).<ref>{{Cite web |last=Services |first=Myers Mortuary & Cremation |title=Obituary for Elisa Hansen {{!}} Myers Mortuary & Cremation Services |url=https://www.myers-mortuary.com/obituary/Elisa-Hansen |access-date=2022-12-03 |website=Obituary for Elisa Hansen {{!}} Myers Mortuary & Cremation Services |language=en}}</ref><ref>{{Cite web |last=Services |first=Myers Mortuary & Cremation |title=Obituary for Lisa Hansen {{!}} Myers Mortuary & Cremation Services |url=https://www.myers-mortuary.com/obituary/Lisa-Hansen |access-date=2023-07-09 |website=Obituary for Lisa Hansen {{!}} Myers Mortuary & Cremation Services |language=en}}</ref>
*[[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.<ref>{{cite news |title=One of nation's famous twins dies |url=https://www.taipeitimes.com/News/taiwan/archives/2019/02/02/2003709106 |access-date=2025-02-27 |work=Taipei Times |agency=CNA |date=2019-02-02}}</ref>
*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.<ref>{{cite web|url=https://www.daat.ac.il/daat/kitveyet/assia_english/drake-1.htm|title=Siamese Twins: The Surgery: An Agonizing Choice – Parents, Doctors, Rabbis In Dilemma|date=1977-10-16|access-date=2020-05-09|website=Philadelphia Inquirer (reprinted)|archive-date=2020-11-26|archive-url=https://web.archive.org/web/20201126014848/http://www.daat.ac.il/daat/kitveyet/assia_english/drake-1.htm|url-status=dead}}</ref>
* [[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.<ref>{{cite news|url=https://www.cnn.com/2018/06/04/health/tanzanian-conjoined-twins-death-intl/index.html|title=Tanzanian conjoined twins die at age 21|date=2018-06-04|work=CNN.com|access-date=2020-01-09|language=en-US}}</ref><ref>{{Cite web |date=2021-04-12 |title=Tanzania mourns famed conjoined twins Maria and Consolata |url=https://www.thecitizen.co.tz/tanzania/news/national/tanzania-mourns-famed-conjoined-twins-maria-and-consolata-2639256 |access-date=2023-07-09 |website=The Citizen |language=en}}</ref>
*[[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.<ref>{{Cite web |date=2018-04-02 |title=Alex Olson |url=https://www.plaintalk.net/obituaries/article_55e9b50a-36b8-11e8-aae9-93f73c0daec7.html |access-date=2023-07-09 |website=Vermillion Plain Talk |language=en}}</ref>
*[[Katie and Eilish Holton (conjoined twins)|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.<ref>{{Citation |title=Two Heads, One Body: The Remarkable Story of Conjoined Twins Katie & Eilish {{!}} Our Life | date=December 23, 2020 |url=https://www.youtube.com/watch?v=SwzV-VdqbDo |language=en |access-date=2022-12-03}}</ref>
*[[Abby and Brittany Hensel|Abigail and Brittany Hensel]] are [[dicephalus|dicephalic]] parapagus twins born on March 7, 1990, in [[Carver County]], [[Minnesota]]. Both graduated in 2012 from [[Bethel University (Minnesota)|Bethel University]], St. Paul, hired as teachers.
*Ashley and Ashil Fokeer, born on November 2, 1992, in [[Mauritius]]<ref>{{cite web|last=Vencatareddy-Nursingen|first=Selvanee|date=2019-01-08|title=Naissance de bébés siamois: émouvante rencontre entre les Papillon et les Fokeer|trans-title=Birth of Siamese babies: A Moving Encounter Between the Papillons and the Fokeers|url=https://www.lexpress.mu/article/345643/naissance-bebes-siamois-emouvante-rencontre-entre-papillon-et-fokeer|access-date=2019-12-18|website=lexpress.mu|language=fr}}</ref>
*[[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.<ref>{{cite web|date=2021-05-26|title=Siameses de Milagro arrancan una nueva etapa en su vida: estudiarán Trabajo Social tras obtener cupos universitarios|trans-title=Siamese twins of Milagro start a new stage in their lives: they will study social work after obtaining university quotas|url=https://www.eluniverso.com/noticias/ecuador/siameses-de-milagro-arrancan-una-nueva-etapa-en-su-vida-estudiaran-trabajo-social-tras-obtener-cupos-universitarios-nota/|access-date=2022-04-13|website=eluniverso.com|language=es}}</ref>

=== 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.<ref>{{Cite news |date=2017-04-22 |title=Conjoined Twins Refuse to Be Separated Despite Doctor's Warnings |url=http://people.com/human-interest/conjoined-twins-refuse-separation-surgery/ |access-date=2017-09-05 |work=PEOPLE.com |language=en-US}}</ref>
*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.<ref>{{cite web|url=https://www.uclahealth.org/news/article/formerly-conjoined-twins-celebrate-21st-birthday|title=Formerly conjoined twins celebrate 21st birthday|publisher=[[UCLA]]|date=August 2, 2022|access-date=August 25, 2024}}</ref>
*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.<ref>{{cite web |title=Rosianne is zus van een Siamese tweeling: 'Als ze overlijden, word ik gek' |url=https://www.linda.nl/persoonlijk/siamese-tweeling-rosianne/}}</ref> 
*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.<ref>{{Cite web |title=Formerly Conjoined Twins and Their Sister Enjoy Being 'Normal' Teenagers 17 Years After Surgery |url=https://people.com/human-interest/formerly-conjoined-twins-sister-enjoy-being-normal-teenagers/ |access-date=2025-07-28 |website=People.com |language=en}}</ref>
*[[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.<ref>{{cite journal |last1=Staffenberg |first1=David A. |last2=Goodrich |first2=James T. |author2-link=James T. Goodrich |title=Separation of craniopagus conjoined twins: an evolution in thought |journal=Clinics in Plastic Surgery |date=January 2005 |volume=32 |issue=1 |pages=25–34 |doi=10.1016/j.cps.2004.09.002 |pmid=15636762 }}</ref>
*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.<ref>{{cite web|url=http://www.mennonews.de/archiv/2005/08/03/der-geburtstag-der-siamesischen-zwillinge-lea-und-tabea-jahrt-sich-zum-zweiten-mal/|title=Der Geburtstag der siamesischen Zwillinge Lea und Tabea jährt sich zum zweiten Mal|website=Mennonews.de|language=de|date=August 3, 2005|access-date=2016-12-09}}</ref>
*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.<ref>{{cite web|url=https://www.ndtv.com/india-news/punjab-assembly-election-2022-goggles-on-for-secrecy-punjabs-conjoined-twins-cast-separate-votes-2778383 |title=Punjab Assembly Election 2022: Goggles On For Secrecy, Punjab's Conjoined Twins Cast Separate Votes |publisher=Ndtv.com |date= |accessdate=2022-03-16}}</ref>
*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.<ref>{{Cite web |date=2007-11-01 |title=Miracle Girl - Washingtonian |url=https://www.washingtonian.com/2007/11/01/miracle-girl/ |access-date=2025-08-28 |language=en-US}}</ref><ref>{{Cite web |date=2004-07-02 |title=Formerly conjoined twins head home |url=http://www.nbcnews.com/health/health-news/formerly-conjoined-twins-head-home-flna1C9447038 |access-date=2025-08-28 |website=NBC News |language=en}}</ref>
*[[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.<ref>{{cite news|url=https://news.bbc.co.uk/1/hi/world/south_asia/7080326.stm|date=2007-11-06|title=Many-limbed India girl in surgery|work=BBC News}}</ref>
* In 2005, a set of conjoined triplets was detected, characterized as tricephalus, tetrabrachius, and tetrapus parapagothoracopagus, and the pregnancy interrupted at 22 weeks.<ref>{{cite journal |last1=Athanasiadis |first1=Apostolos P. |last2=Tzannatos |first2=Christinne |last3=Mikos |first3=Themistoklis |last4=Zafrakas |first4=Menelaos |last5=Bontis |first5=John N. |title=A unique case of conjoined triplets |journal=American Journal of Obstetrics and Gynecology |date=June 2005 |volume=192 |issue=6 |pages=2084–2087 |doi=10.1016/j.ajog.2004.10.622 |pmid=15970906 }}</ref>
* [[Kendra and Maliyah Herrin]], ischiopagus twins separated in 2006 at age 4<ref>{{cite web|title=Herrin Twins|url=http://www.herrintwins.com|url-status=dead|archive-url=https://web.archive.org/web/20140606220423/http://www.herrintwins.com/|archive-date=2014-06-06|access-date=2014-08-03}}</ref>
*[[Krista and Tatiana Hogan]], [[Canadians|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.
*{{anchor|Trishna and Krishna}}[[Moira Kelly, AO#Twins|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.<ref>{{cite web|url=https://www.pbs.org/wgbh/nova/video/separating-twins/ |series=NOVA |title=Separating Twins |publisher=Pbs.org |date=February 8, 2012 |access-date=2014-08-03}}</ref>
*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.<ref>{{Cite web |last=Digitale |first=Erin |date=2011-11-02 |title=Conjoined twin toddlers successfully separated at Packard Children's |url=https://med.stanford.edu/news/all-news/2011/11/conjoined-twin-toddlers-successfully-separated-at-packard-childrens.html |access-date=2025-07-28 |website=News Center |language=en-US}}</ref>

=== 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.<ref>{{Cite web |last=Philadelphia |first=The Children's Hospital of |title=Conjoined Twins: Amelia and Allison’s Story {{!}} Children's Hospital of Philadelphia |url=https://www.chop.edu/stories/conjoined-twins-amelia-and-allison-s-story |access-date=2025-08-28 |website=www.chop.edu |language=en}}</ref>
*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.<ref>{{cite web|url=http://www.shanghaidaily.com/metro/health-and-science/Conjoined-twins-to-be-separated/shdaily.shtml|title=Conjoined twins to be separated|website=ShanghaiDaily.com|date=July 15, 2014|last=Cai|first=Wenjun|access-date=2017-06-15}}</ref><ref>{{cite web|url=http://www.chinadaily.com.cn/china/2014-07/18/content_17830845.htm|title=Conjoined girls separated in surgery|last=Wang|first=Hongyi|website=Chinadaily.com.cn|date=July 18, 2014|access-date=2017-06-15}}</ref>
*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.<ref>{{Cite web |title=Mata conjoined twins successfully separated in complex, first-of-its-kind surgery at Texas Children's Hospital {{!}} Texas Children's |url=https://www.texaschildrens.org/content/news/mata-conjoined-twins-successfully-separated-complex-first-its-kind-surgery-texas |access-date=2025-07-28 |website=www.texaschildrens.org |language=en}}</ref><ref>{{Cite web |date=2019-08-23 |title=Formerly conjoined twins, 5, mark new milestone. See how they're doing now! |url=https://www.today.com/health/formerly-conjoined-mata-twins-are-now-5-start-pre-k-t161256 |access-date=2025-07-28 |website=TODAY.com |language=en}}</ref>
*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.<ref>{{Cite web |last=Marcus |first=Mary Brophy |date=2016-03-29 |title=Conjoined Texas twins, Ximena and Scarlett Hernandez-Torres, get set for separation surgery - CBS News |url=https://www.cbsnews.com/news/conjoined-texas-twins-set-for-surgery/ |access-date=2025-07-28 |website=www.cbsnews.com |language=en-US}}</ref><ref>{{Cite web |last=Howley |first=Christopher |title=Formerly conjoined Texas sisters continue to beat the odds years after separation surgery |url=https://www.caller.com/story/news/2021/04/12/formerly-conjoined-texas-sisters-lead-healthy-lives-years-after-surgery/7160685002/ |access-date=2025-07-28 |website=Corpus Christi Caller-Times |language=en-US}}</ref>
*[[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.<ref>{{cite web|url=https://www.today.com/health/doctors-successfully-separate-twins-joined-skulls-t103979|author=Meghan Holohan|title=Formerly conjoined twins recovering, gaining mobility after separation|date=2016-10-14}}</ref><ref>{{cite web|url=https://www.today.com/health/formerly-conjoined-twins-are-home-enjoying-life-toddlers-t117926|author=Meghan Holohan|title=Formerly conjoined twins are finally home 1 year after epic surgery|date=2017-10-26}}</ref><ref>{{Cite web |last=Gupta |first=Wayne Drash,Dr Sanjay |date=2019-01-01 |title=For parents of separated twins, inspiration and heartache |url=https://www.cnn.com/2019/01/01/health/conjoined-twins-jadon-and-anias-update |access-date=2025-08-28 |website=CNN |language=en}}</ref>
*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 <ref>{{cite web|url=https://www.chop.edu/news/formerly-conjoined-twins-erin-and-abby-delaney-thriving-months-after-separation-surgery|title=Formerly conjoined twins, Erin and Abby Delaney, thriving months after separation surgery|website=Children's Hospital of Philadelphia|date=October 22, 2017|access-date=2018-11-27}}</ref><ref>{{Cite web |title=Formerly Conjoined Twins, 6, Graduate Kindergarten: ‘The Sky Is the Limit for Them’ Says Mom |url=https://people.com/formerly-conjoined-twins-graduate-kindergarten-7554070 |access-date=2025-08-28 |website=People.com |language=en}}</ref>
*Anna and Hope Richards were born December 29, 2016, at Texas Children’s, conjoined at their chest and abdomen, sharing a chest wall, [[Pericardium|pericardial sac]], diaphragm, liver, and a large blood vessel connecting their hearts. They were separated on January 13, 2017.<ref>{{Cite web |title=A chance for a normal life {{!}} Texas Children's |url=https://www.texaschildrens.org/content/media/chance-normal-life |access-date=2025-08-28 |website=www.texaschildrens.org |language=en}}</ref>
*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.<ref>{{cite news|url=https://www.bbc.co.uk/news/resources/idt-sh/Wales_conjoined_twins|title=Two girls, one body|work=BBC News|first=Gwyneth|last=Rees|date=January 23, 2019}}</ref><ref>{{Cite news |date=2024-02-17 |title=Conjoined twins given days to live are proving world wrong |url=https://www.bbc.com/news/uk-wales-68145224 |access-date=2025-08-28 |language=en-GB}}</ref>
*Callie and Carter Torres, born January 30, 2017, in Houston Texas, from Blackfoot Idaho. They are [[Ischiopagi|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.<ref>{{cite web|title=Conjoined twins in Blackfoot continue to beat the odds {{!}} The Spokesman-Review|url=https://www.spokesman.com/stories/2018/jan/24/conjoined-twins-in-blackfoot-continue-to-beat-the-/|access-date=2020-07-27|website=www.spokesman.com|date=January 24, 2018 }}</ref><ref>{{Cite web |date=2023-04-03 |title=A mom used to hide her conjoined twins. Now she shares their joy with the world |url=https://www.today.com/parents/family/chelsea-torres-shares-life-conjoined-twins-rcna77692 |access-date=2025-08-28 |website=TODAY.com |language=en}}</ref>
*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.<ref>{{cite web|title=Second set of rare conjoined twins separated at Great Ormond Street Hospital in less than 12 months|url=https://www.gosh.nhs.uk/news/second-set-rare-conjoined-twins-separated-great-ormond-street-hospital-less-12-months|access-date=2020-07-27|website=www.gosh.nhs.uk|language=en}}</ref><ref>{{cite web|title=Separation of conjoined twins in London children's hospital 'a Moses moment'|url=https://www.thenational.ae/world/europe/separation-of-conjoined-twins-in-london-children-s-hospital-a-moses-moment-1.1032402|access-date=2020-07-27|website=The National|date=June 12, 2020 |language=en}}</ref>
*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.<ref>{{cite news|author1=Jack Guy|author2=Sharon Braithwaite|title=Twin girls, joined at the skull, successfully separated in Vatican hospital|url=https://www.cnn.com/2020/07/08/health/conjoined-twins-separated-vatican-scli-intl/index.html|access-date=2020-07-09|website=CNN}}</ref>
*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.<ref>{{cite news|url=https://www.cnn.com/2020/01/08/africa/nigerian-conjoined-twins-separated-intl/index.html|title=Nigerian conjoined twins successfully separated by 78-member team in Abuja|work=CNN.com|date=January 8, 2020|language=en-US}}</ref>
*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.<ref>{{Cite web |date=2021-12-02 |title=Inside the Successful Separation Surgery of Conjoined Twins |url=https://www.cuimc.columbia.edu/news/inside-successful-separation-surgery-conjoined-twins |access-date=2025-07-28 |website=Columbia University Irving Medical Center |language=en}}</ref>
*Marie-Cléa and Marie-Cléanne Papillon, born in Mauritius in 2019.<ref>{{cite web|url=https://www.lexpress.mu/article/365556/separee-sa-soeur-siamoise-cleanne-ou-joie-vivre|title=Séparée de sa soeur siamoise: Cléanne ou la joie de vivre|trans-title= Separated from her Siamese sister: Cléanne or the Joy of Living|last=Carpayen|first=Shelly|date=2019-11-17|website=lexpress.mu|language=fr|access-date=2019-12-18}}</ref> Conjoined from neck to abdomen, but also at the heart, which had seven chambers, instead of four.<ref>{{cite web|url=https://ionnews.mu/marie-cleanne-papillon-le-3e-bebe-siamois-miracule-au-monde-selon-son-chirurgien-28052019/|title=Marie-Cléanne Papillon : Le 3e bébé siamois miraculé au monde, selon son chirurgien |date=May 28, 2019 }}</ref> Marie-Cléa did not survive the surgery to separate the two.<ref>{{cite web|url=https://www.lexpress.mu/article/349919/jumelles-siamoises-marie-clea-papillon-inhumee-ce-mardi|title=Jumelles siamoises: Marie-Cléa Papillon inhumée ce mardi|trans-title=Siamese Twins: Marie-Cléa Papillon buried this Tuesday|date=2019-03-26|website=lexpress.mu|language=fr|access-date=2021-10-02}}</ref>
*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.<ref>{{Cite web |date=2019-05-15 |title=Separated conjoined twins doing well in Zagreb |url=https://www.croatiaweek.com/separated-conjoined-twins-doing-well-in-zagreb/ |access-date=2023-06-09 |website=Croatia Week |language=en}}</ref><ref>{{Cite journal |last1=Grizelj |first1=Ruža |last2=Sindičić Dessardo |first2=Nada |last3=Bulić |first3=Krešimir |last4=Luetić |first4=Tomislav |last5=Mikulić |first5=Danko |last6=Antabak |first6=Anko |last7=Sjekavica |first7=Ivica |last8=Alduk |first8=Ana Marija |last9=Konosić |first9=Sanja |last10=Režek Tomašić |first10=Karolina |last11=Ćaleta |first11=Tomislav |last12=Pleško |first12=Sanja |last13=Šarić |first13=Dalibor |last14=Vuković |first14=Jurica |date=August 2019 |title=Successful separation of xypho-omphalopagus conjoined twins with extrauterine twin-twin transfusion syndrome: a case report |journal=Croatian Medical Journal |volume=60 |issue=4 |pages=301–308 |doi=10.3325/cmj.2019.60.301 |issn=0353-9504 |pmc=6734570 |pmid=31483115}}</ref>
*Sarabeth and Amelia Irwin were born June 11, 2019, sharing a chest wall, sternum, pericardium and liver. They were separated at [[C.S. Mott Children's Hospital|Mott Children's Hospital]] on August 5, 2020.<ref>{{Cite web |last=Shamus |first=Kristen Jordan |title=Rare conjoined twins, born locked in embrace, successfully separated in Michigan |url=https://www.freep.com/story/news/local/michigan/2020/09/18/conjoined-twins-michigan-sarabeth-amelia-irwin/5741856002/ |access-date=2025-08-28 |website=Detroit Free Press |language=en-US}}</ref>
*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.<ref>{{Cite web |date=2021-01-19 |title=Tiny twins with a big fight: Conjoined sisters survive separation |url=https://www.childrensmn.org/blog/tiny-twins-big-fight-conjoined-sisters-survive-separation/ |access-date=2025-08-28 |website=Children's Minnesota |language=en-US}}</ref><ref>{{Cite web |date=2024-01-09 |title=Parents of formerly conjoined twins in Elk River search for help finding nurse |url=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 |access-date=2025-08-28 |website=kare11.com |language=en-US}}</ref>
*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.<ref>{{Cite web |last=Hospital |first=Children's |title=Rare set of conjoined twins successfully separated in 24-hour surgery at UC Davis Children's Hospital |url=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 |access-date=2025-07-28 |website=children}}</ref>

=== 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.<ref>{{Cite web |last=Philadelphia |first=The Children's Hospital of |title=The Story of Addy and Lily: Birth and Separation of Conjoined Twins {{!}} Children's Hospital of Philadelphia |url=https://www.chop.edu/stories/story-addy-and-lily-birth-and-separation-conjoined-twins |access-date=2025-07-28 |website=www.chop.edu |language=en}}</ref>
*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.<ref>{{cite news |last1=Robinson |first1=Carol |title=Alabama conjoined twin girls born at Philadelphia hospital: 'We love them so much' |url=https://www.al.com/news/2021/04/alabama-conjoined-twin-girls-born-at-philadelphia-hospital-we-love-them-so-much.html |access-date=18 June 2023 |publisher=AL.com |date=22 April 2023}}</ref>
*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 ([[Ischiopagi|ischiopagus]]). The boys were successfully separated on August 17, 2022 at [[Texas Children's Hospital]].<ref>{{Cite web |date=2023-07-17 |title=Texas Children's Hospital announces successful separation of conjoined twin brothers Lucas and Mateo {{!}} Texas Children's |url=https://www.texaschildrens.org/content/media/texas-childrens-hospital-announces-successful-separation-conjoined-twin-brothers |access-date=2025-08-28 |website=www.texaschildrens.org |language=en}}</ref>
*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]].<ref>{{Cite web |date=2022-04-22 |title='Miracle' Conjoined Twins Born Fused at Chest 'Constantly Hug Each Other' |url=https://www.newsweek.com/conjoined-twins-born-fused-chest-annabelle-isabelle-bateson-1700049 |access-date=2025-08-28 |website=Newsweek |language=en}}</ref><ref>{{Cite web |title=Conjoined twins Annie and Issie return home for Christmas after separation surgery |url=https://www.gosh.nhs.uk/news/conjoined-twins-annie-and-issie-return-home-for-christmas-after-separation-surgery/ |access-date=2025-08-28 |website=GOSH Hospital site |language=en-GB}}</ref>
*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.<ref>{{Cite web |last=Gartner |first=Jordan |title=Conjoined twin sisters separated in successful surgery: 'We did it' |url=https://www.kbtx.com/2023/01/27/conjoined-twin-sisters-separated-successful-surgery-we-did-it/ |access-date=2023-01-30 |website=www.kbtx.com |date=January 27, 2023 |language=en}}</ref>
*Ella and Eliza Fuller were born at [[Texas Children's Hospital|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.<ref>{{Cite web |title=Formerly Conjoined Twins Celebrate 1st Birthday: 'They Are So Incredibly Strong,' Mom Says |url=https://people.com/formerly-conjoined-twins-ella-eliza-fuller-celebrate-1st-birthday-8610454 |access-date=2025-08-28 |website=People.com |language=en}}</ref><ref>{{Cite web |date=2023-07-12 |title=These formerly conjoined twins spent 134 days in the hospital in Texas. Now they're finally home. - CBS News |url=https://www.cbsnews.com/news/texas-conjoined-twins-ella-eliza-fuller/ |access-date=2025-08-28 |website=www.cbsnews.com |language=en-US}}</ref>
*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.<ref>{{Cite web |title=Couple Who Welcomed Conjoined Twins Say They Cherished the Hour Their 'Beautiful' Girls Were Alive (Exclusive) |url=https://people.com/outpouring-of-support-after-georgia-couple-conjoined-twins-survived-an-hour-8690805 |access-date=2025-08-28 |website=People.com |language=en}}</ref>
*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.<ref>{{Cite web |last=Philadelphia |first=The Children's Hospital of |title=Birth and Separation of Conjoined Twins: Amari and Javar’s Story {{!}} Children's Hospital of Philadelphia |url=https://www.chop.edu/stories/birth-separation-conjoined-twins-amari-javar |access-date=2025-08-28 |website=www.chop.edu |language=en}}</ref> 

==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 (Lansens novel)|The Girls]]'' (2005) is the life story of craniopagus twin sisters.
* Irish author [[Sarah Crossan]]'s [[verse novel]] [[One (Crossan novel)|''One'']] follows the life and survival of conjoined twin sisters. It won the [[Carnegie Medal (literary award)|Carnegie Medal]], ''[[The Bookseller]]''{{'s}} 2016 prize for young adult fiction, and the [[CBI Book of the Year Awards|Irish Children's Book of the Year]].<ref name="Drabble">{{Cite news|url=https://www.theguardian.com/childrens-books-site/2016/jun/20/sarah-crossan-carnegie-medal-2016-one|title=Sarah Crossan wins the Carnegie medal with verse novel One|last=Drabble|first=Emily|date=2016-06-20|work=The Guardian|access-date=2017-04-13|language=en-GB|issn=0261-3077}}</ref>
* [[Lidija Dimkovska]]'s {{ill|A Spare Life|mk|Резервен живот (роман)|lt=''A Spare Life''}} ({{lang|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 (game)|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.

==See also==
* [[Medical law]]
* [[Monoamniotic twins]]
* [[Polycephaly]]

==Notes==
{{Notelist}}

==References==
{{reflist}}

==External links==
{{Commons category|Conjoined twins}}
* [https://web.archive.org/web/20051025160942/http://zygote.swarthmore.edu/cleave4.html Types and social history of conjoined twins]
* [https://web.archive.org/web/20060222112439/http://www.conjoinedtwins.med.sa/ The site of the medical Saudi team responsible for numerous successful separation surgeries]
* [https://web.archive.org/web/20060823014955/http://www.lib.unc.edu/ncc/gallery/twins.html Eng and Chang – The Original Siamese Twins; The University of North Carolina at Chapel Hill, The North Carolina Collection Gallery]
* [http://www.thehumanmarvels.com/ The Human Marvels: A Historical Reference Site run by J. Tithonus Pednaud, Teratological Historian]
* [http://www.phreeque.com/ Cases of conjoined and incomplete twins] {{Webarchive|url=https://web.archive.org/web/20060610181005/http://phreeque.com/ |date=2006-06-10 }}
* [https://web.archive.org/web/20041105080116/http://profiles.nlm.nih.gov/QQ/B/B/Y/Q/_/qqbbyq.pdf 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]]
* [https://www.nlm.nih.gov/hmd/conjoined/index.html National Library of Medicine: Selected Moments in the History of Conjoined Twins]
* [http://www.cnn.com/2013/07/11/world/conjoined-twins-fast-facts/ Conjoined Twins Fast Facts] (also lists additional twins) 
* [http://www.emedicine.com/ped/topic2936.htm Emedicine article] (this article includes post-mortem images)
* [http://arquivo.pt/wayback/20091015164025/http://www3.telus.net/tyee/multiples/conjoined.html Facts About Multiples: Conjoined Records and stats]
*"[https://books.google.com/books?id=p4o9AQAAIAAJ The St. Benoit Twins]", ''[[Scientific American]]'', July 13, 1878, p.&nbsp;24

{{Medical resources
| DiseasesDB     = 34474
| ICD10          = {{ICD10|O|33|7|o|30}}, {{ICD10|Q|89|4|q|80}}
| ICD9           = {{ICD9|678.1}}, {{ICD9|759.4}}
| ICDO           =
| OMIM           =
| MedlinePlus    =
| eMedicineSubj  = ped
| eMedicineTopic = 2936
| MeshID         = D014428
}}
{{Situs inversus and conjoined twins}}
{{Authority control}}
{{DEFAULTSORT:Conjoined Twins}}
[[Category:Conjoined twins| ]]
[[Category:Rare diseases]]