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Ischiopagus tetrapus conjoined twins

Two sets of ischiopagus conjoined twins were successfully operated on at the University Hospital, Kuala Lumpur in 1981 and 1982. The anatomy of the organ and system malformations are discussed which determined the technique of reconstruction after surgical separation to obtain optimum cosmetic and functional results. Permanent colostomy was not required in any of the four twins and in only one twin was there a need for urinary diversion.