Delayed cure of an omphalocele requiring abdominosternoplasty, right hepatectomy and partial splenectomy

A large ventral hernia resulting from the primary treatment of an omphaloce le according to the Gross technique was repaired at age 16. The girl presen ted with extra-abdominal development of the liver and the spleen along with hypotrophy of the abdominal and thoracic cavities. The operation included enlargement sternoplasty, liver and spleen-size reduction and prosthetic ab dominal closure. The cosmetic and functional results are good and stable on 7-year follow-up. Surgical issues and blood transfusion policy are discuss ed. A multi-disciplinary pediatric surgical approach is advocated.