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Baby with four legs and arms undergoes successful surgery

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Medics prepare Mukisa for the operation at Mulago PHOTO BY RACHEAL MABALA 

By Agatha Ayebazibwe

Posted  Wednesday, September 3  2014 at  01:00

In Summary

Special case. Mukisa was born with an extra two legs, an extra two arms and something else that looked like a chest but did not fully develop.

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Kampala.

On a normal day, ward 2C, paediatric ward at Mulago hospital has at least 20 children admitted for different ailments – but none like that of three-months-old Paul Mukisa.
For the two weeks he has been at this ward, Mukisa remains one of the few unique cases that nurses, neighbours and other parents at the ward have seen in their lifetime.

Happy mum

Mukisa soon after the operation. PHOTO BY Rachel Mabala

Lying on his hospital bed, little Mukisa, comes off as a normal child – if you chose to just look at his face, arms and legs – all moving normally. His mother Margaret Awino cannot hide her joy as she repeatedly thanks the doctors who performed a ‘miracle’ on her child.

“I still can’t believe that my child is normal. I didn’t know what to do with him but I am very happy he was operated for free,” said the 35-year-old mother of five.
But until two weeks ago, Mukisa had extra two legs, extra two arms and something else that looked like a chest but did not fully develop to become one, a condition medics called parasitic twin.
The condition only occurs when an undeveloped or underdeveloped twin is attached to parts of the body of the twin that develops and is birthed.

When the baby was born in May, his parents, Mr Benefanco Okongo and Ms Margaret Owino, residents of Nabijingo, Bulinda Sub-county in Bugiri District, were shocked

Looking for help
They sought immediate help at Bugiri Hospital but the health workers at the facility referred them to Mulago, saying they did not have the capacity to help the baby.
At Mulago hospital, a team of surgeons led by Dr John Sekabira, a consultant paediatric surgeon, investigated the case and assessed the extent of the anomaly.

According to Dr Nasser Kakembo, one of the surgeons that operated on the child, several other anomalies were revealed, including the heart and liver which were located on the wrong side.
“Whenever a baby is born with an abnormality, we don’t take it for granted because we believe that there are other hidden abnormalities which is why we take time to investigate before we make a decision to either do surgery immediately or wait,” said Dr Kakembo.

In future, Mukisa may need to undergo another surgery to make him walk better. Before that, he will walk but with a wide gait because of the gap between his legs, according to Dr Kakembo.
During the two and half hours operation, a team of three surgeons, four anesthesiologists and five nurses successfully separated parts of the parasitic twin from the normal baby.

“We removed the trunk, separated the left leg and the right leg from those of the abnormal twin,” said Kakembo adding that the baby’s two weeks after surgery have been very promising and that he will be discharged in another two weeks after his wound has healed.

Future surgery
In future, he may need to undergo another surgery (cosmetic) to make him walk better. For now, when time to walk comes, he will walk but with a wide gait because of the big gap between his legs, according to Dr Kakembo.

Dr Kakembo says they handle different congenital anomalies or children born with abnormalities but this was the first that they have operated at the hospital.

what are parasitic twins?
How they come about. Parasitic twins are asymmetric conjoined twins in which the tissues of a severely defective twin (parasite) are dependent on the cardiovascular system of the other, intact twin for survival.

Incidence. The estimated incidence of parasitic twins is approximately 1 per 1 million live births. The condition only occurs when an undeveloped or underdeveloped twin is attached to parts of the body of the twin that develops and is birthed.

aayebazibwe@ug.nationmedia.com