Published online June 26, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. e220-e223 (doi:10.1542/peds.2005-3001)
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EXPERIENCE AND REASON

Multidisciplinary Surgical Approach to a Surviving Infant With Sirenomelia

Antonio Messineo, MDa, Marco Innocenti, MDb, Riccardo Gelli, MDc, Simone Pancani, MDa, Roberto Lo Piccolo, MDa and Alessandra Martin, MDa

a Department of Pediatric Surgery and Burn Unit, Anna Meyer Children's Hospital, Florence, Italy
b Department of Microsurgery, Careggi Hospital, Florence, Italy
c Department of Plastic and Reconstructive Surgery, S. Maria Annunziata Hospital, Florence, Italy

Sirenomelia is an extremely complex and rare malformation with different degrees of lower-extremities fusion associated with gastrointestinal, musculoskeletal, vascular, cardiopulmonary, and central nervous system malformations. In the English literature, there are only 5 reports of infants surviving with this condition. In our case, a 2540-g female infant was born with normal vital signs, no facial dysmorphism, and a complete soft tissue fusion of the lower limbs, from perineum to ankles. Radiologic examinations revealed an intestinal atresia and a single pelvic kidney, with a unique ureter, 2 femurs, 2 tibias, 2 fibulas, and 2 feet (simpus dipus). At 7 months of age, a multidisciplinary surgical team achieved complete separation of the lower limbs, with independent vascular and nerve supplies. At the time of this writing, the infant was 28 months old and had a regular growth curve. Many future reconstructive surgeries have been planned to achieve an acceptable quality of life for this infant.

Key Words: mermaid syndrome • sirenomelia

Accepted Feb 7, 2006.