Ischiopagi comes from the Greek word ischio- meaning hip (ilium) and -pagus meaning fixed or united. It is the medical term used for conjoined twins (Class V) who are united at the pelvis. The twins are classically joined with the vertebral axis at 180°. However, the most frequent cases usually structures the ischiopagus twins with two separate spines forming a lateral angle smaller than 90°. The conjoined twins usually have four arms; two, three or four legs; and typically one external genitalia and anus.It is mostly confused with pygopagus where the twins are joined dorsally at the buttocks facing away from each other, whereas ischiopagus twins are joined ventrally and caudally at the sacrum and coccyx. Parapagus is also similar to ischiopagus; however, parapagus twins are joined side-by-side whereas ischiopagus twins typically have spines connected at a 180° angle, facing away from one another. Classification
Ischiopagus Dipus: This is the rarest variety with the twins sharing two legs with no lower extremities on one side. Ischiopagus Tripus: This is the most common variety. These twins share three legs, the third leg is often two fused legs, or is non-functioning. The twins also usually share only one set of external genitalia. Ischiopagus Tetrapus/Quadripus: This variety has the twins at a symmetrical continuous longitudinal axis with their area of union not broken anteriorly. The axes extends in a straight line but in opposite directions.
Fibrosing colonopathy is a disease that arises in people with cystic fibrosis treated with high doses of pancreatic enzyme supplements. Symptoms are non-specific with abdominal pain, abdominal swelling, vomiting, and constipation.Risk factors include being young, prior surgery of the intestines, and the use of certain medications including corticosteroids and H2 blockers. It may appear similar to distal intestinal obstruction syndrome or inflammatory colitis such as Crohns disease.A maximum dose of 10,000 IU of lipase per kilogram per day is recommended for pancreatic enzyme supplementation to prevent this condition. More than 60 cases have been described as of 1999. The disease was suggested to be caused by methacrylic acid copolymer which is used as coating for delayed release of enzymes but there is no reliable evidence for that. == References ==