Report of an autopsy on the bodies of Chang and Eng Bunker, commonly known as the Siamese twins

by Harrison Allen

1. The umbilical ligaments.[^[2]]—By turning forward the anterior flap in Eng as far as possible, the peritoneal lining was exhibited, and there was brought into view a structure beginning at the summit of the bladder, and which, ascending the abdominal wall and passing obliquely to the right side, could be traced clearly to the scar-like tissue marking the remains of the umbilical structures situated upon the anterior abdominal wall within about 1-¹/₂ in. of the band. This structure was the umbilical ligament (Fig. [4], A). It was loaded with fat, and, as it terminated at the scar, distinct lobules of fat (several of which were pedunculated) were abundantly deposited.

The bladder was distended and raised 5 in. above the pubis.

Fig. 4. The umbilical ligament in Eng. A. The umbilical ligament. B. The lobule of fat at position of the normal umbilicus.

In Chang (Fig. [5]), the same appearances were seen as those above given, save that no fat was deposited in the umbilical ligament. On the contrary, it resembled the omentum of an emaciated subject. When stretched, the fold was fully an inch wide, quite transparent, and marked by two longitudinal bands, which recalled the shapes of the obliterated vessels. But two rather small sessile fatty appendages were seen at the scar.

The bladder was empty, contracted, and lay within the true pelvis.

Fig. 5. The umbilical ligament in Chang. A. The umbilical ligament. B. The lobule of fat at position of the normal umbilicus.

In both Chang and Eng an isolated mass of subperitoneal fat, presenting a sub-circular form, and measuring 1 in. in diameter, was found in the position of the normal umbilicus (Figs. [4] and [5]).

2. The viscera.—In Eng the omentum was gathered up toward the transverse colon. It was abundantly furnished with fat.[^[3]] The transverse colon extended across the abdomen, beginning on the right side on a level with the eleventh rib. It was contracted and contained a little flatus. The rest of the exposed region was occupied by coils of small intestine, yielding a mesentery very rich in fat. The stomach was not visible. By removing the small intestine, and bringing down the transverse colon and large intestine, the pyloric extremity of the stomach was seen. The fundus of stomach, spleen, and left kidney were not seen. (Fig. [6].)