Anal canal duplications occurring in a pair of 4 month-old healthy female twins are presented. The openings were located in the posterior midline of the anus since birth without a history of perianal abscess or swelling. Excision of the duplicated anal canals was performed using posterior sagittal approach. Although the anal canal duplication occurs predominantly in female, to our knowledge, this is the first case of anal duplication in a monozygotic female twins reported.

Conjoined twins are one of the rarest and most challenging congenital anomalies in pediatric surgery. Successful surgical separation is difficult because it the majority of conjoined twins in is technically typical to separate shared vital organs successfully. The timing of separation is variable, but separation is usually delayed until such infants are relatively mature(i.e, 9-12 months of age). Operative survival was 50 % in the neonatal period, but 90 % in those over 4 months of age. The present case was successfully separated early beacase of cardiac problems in one of the twins. These twins were omphalopagus and only the liver was shared through a bridge. The vascular and biliary trees were independent from each other. Successful surgical separation was on 11th day of life, but one died of sepsis 18 days ofter operation.