Jakarta, Indonesia

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In an extremely rare case, conjoined twins were born in Indonesia with four arms, three legs, and shared genitalia. These twins, scientifically termed as ischiopagus tripus, are born only once in two million births. Known colloquially as 'spider twins', only a few instances of such conjoined twins have been documented. The case of Indonesian boys was recently published in the American Journal of Case Reports, although they were born in 2018.

"The rarity of ischiopagus tripus conjoined twins complicates the surgical separation, owing to the lack of cases and high complexity," the authors wrote in the American Journal of Case Reports.

They are described as those who are joined at the lower half of their bodies rather than at the upper torso.

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In over 60 per cent of such cases, one of the twins typically dies post birth or is stillborn. Nevertheless, these infants defied the odds. However, due to their unique body structure, the brothers had to remain in a flat position for their initial three years, unable to sit up.

According to the case report, surgeons conducted an amputation of their third leg, which usually consists of two fused legs, and stabilised their hips and legs to enable the brothers to sit upright independently. A follow-up appointment three months after the surgery showed no complications.

The twins remain conjoined, and it remains uncertain whether doctors will attempt such a complex separation surgery.

Births like these occur when the embryo incompletely separates to develop into two individuals due to a congenital birth defect, according to Mayo Clinic. As the babies develop from this embryo, they remain physically connected, most frequently at the chest, abdomen, or pelvis.

World’s oldest conjoined twins, Lori and George Schappell die

Just last month, the world’s oldest conjoined twins ever, Lori and George Schappell, passed away at a hospital in Pennsylvania, United States, the Guinness World Records confirmed.

At the time of their passing, the twins were 62 years and 202 days old, marking them as nine years senior to the second-oldest recorded female conjoined twins, as per the Guinness World Records. The reason for their death was not disclosed.

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Their heads were partly joined together, they shared important blood vessels, and around 30 per cent of their brains were shared.

In 2007, they were the first conjoined twins of the same sex to identify as different genders when George decided to live as a man.

(With inputs from agencies)