Delayed three-stage closure of giant omphalocele using pericard patch.

The management of giant omphaloceles in a single operative approach is quite difficult. If performed as a single-stage procedure, postoperative complications are encountered, which are usually related to significant changes in intra-abdominal pressures, compromise of interior venous blood return ,and hemodynamic and respiratory instability due to diaphragmatic elevation. We report the case of a giant omphalocele that required a three-stage delayed closure and was managed using bovine pericard patches. The procedure of staged application of pericard patches is described. Delayed staged closure has the advantage of avoiding multiple surgical procedures in the neonatal period and reduces morbidity in the management of giant omphaloceles.