A rare case of heteropagus twin managed in his preadolescence at a rural tertiary level medical institute

Introduction: Parasitic or heteropagus twins are asymmetric conjoined twins in whom the severely defective twin (parasite) is depended on intact twin (autosite) for its vascular supply and growth. It is an extremely rare condition with estimated incidence of less than one per million live births. Case Report: A case of this rare entity which presented to us late in his preadolescence. The parasite had partially developed pelvis, lower limbs, nipples, hairs, nails and loops of the intestine. The case was successfully managed at a rural tertiary level institute. Conclusion: Parasitic or heteropagus twin is a extremely rare condition which require detailed evaluation to diagnose the degree of vascular, organ and soft tissue attachments before successful surgical excision.