Interesting Case Series Giant Omphalocele Treated With Intramuscular Tissue Expansion

graft over allogenic dermis graft. A 6-year-old girl had undergone multiple operations for an omphalocele but still retains a very large ventral hernia. She presented with an eventrated abdomen with unstable, scarred closure (see Fig. 1). A reconstruction using intermuscular tissue expanders was performed. QUESTIONS 1. What defines an omphalocele as giant? 2. What are the different techniques employed to close giant omphaloceles? 3. Is there a benefit to a staged approach compared to a primary closure? 4. What are the risks associated with the use of tissue expanders? DISCUSSION A giant omphalocele is a congenital abdominal wall defect caused by failure of the cephalic, caudal, and lateral folds to fuse at the umbilical ring during the fourth week of gestation.1 Fifty percent of infants with omphalocele also have other abnormalities, either structural or chromosomal.2 Staged closure, external silo reduction, and subcutaneous or intermuscular tissue expanders are surgical options employed for closure. In this article, we presen