Management of giant omphalocele: a case series

Giant omphalocele (GO) is congenital abdominal wall defect measuring >6 cm and/or containing liver.[1] The omphalocele sac consists of amnion and peritoneum, and is prone to rupture either in utero, during delivery or after birth. The surgical management of neonates with GO is challenging. Several operative and nonoperative strategies have been described although a traditional silo chimney with graduated visceral reduction is commonly used. In this case report, we describe four patients with GO in whom postnatal management was highly problematic. We used an acellular biological xenograft called Surgisis Biodesign® (Cook Ltd.) to repair the GO.[2] Surgisis Biodesign is derived from porcine small intestine submucosa and consists of an extracellular matrix containing collagens, glycoproteins glycosaminoglycans, proteoglycans, and growth factors.[2] Once implanted into tissue it provides a scaffold for epithelialization.