A rare variety of ischiopagus tetrapus conjoined twins

Ischiopagus is a very rare variety of conjoined twins with very few cases reported in the literature. A case of ischiopagus-tetrapus conjoined twins is reported here. Twins were fused at the lower halves of the bodies. There were four well-formed separate lower limbs. The twins had two anal openings for passage of both urine and stool. In general, female predominance is found in conjoined twins. But this particular case, where external genitalia were absent making gender determination difficult, is even more unusual among the rare type. Follow-up of the twins was not possible, as they passed away during pre-operative procedure.