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Case Reports
. 2023 Aug:109:108512.
doi: 10.1016/j.ijscr.2023.108512. Epub 2023 Jul 19.

Pediatric patient with a complex Abdominal Wall defect reconstructed with sandwich omental flap. A case report

Daniel Odhiambo Otieno  1 , Janan Malik  2 , Benjamin Wabwire  3
Affiliations
Case Reports

Pediatric patient with a complex Abdominal Wall defect reconstructed with sandwich omental flap. A case report

Daniel Odhiambo Otieno et al. Int J Surg Case Rep. 2023 Aug.

Abstract

Introduction and importance: Low grade Fibromyxoid sarcoma (LGFMS) is a rare soft tissue sarcoma. LGFMS has an indolent clinical behavior but it is prone for late local recurrence and metastasis. In children it is commonly seen in the subcutaneous tissues relative to adults where it presents in deep soft tissues. These patients are best managed in a specialized unit with a multidisciplinary team. For patients with sarcoma, wide local excision remains the treatment of choice. Large complex abdominal wall defects present a unique reconstructive challenge to the surgeon following tumor removal.

Case presentation: Here, we present a case of a 9-year old pediatric male patient with complex abdominal wall defect post excision of a recurrent fibromyxoid sarcoma, reconstructed with a sandwich omental flap, monofilament polypropylene mesh (Bard® Mesh) and split-thickness skin graft (STSG).

Clinical discussion: Despite the success of covering the defect, the patient still had quite a bit of morbidity with the following:abdominal hernia defect and tumor recurrence. Our case demonstrates the diagnostic and therapeutic challenges in management of sarcomas hence the need for these patients to be managed through a multidisciplinary approach.

Conclusion: The omental flap is quite versatile, and knowing how to raise it does not require sophisticated microsurgical skills. It adds to the reconstructive surgeon's armamentarium, especially in resource-limited settings.

Keywords: Abdominal wall reconstruction; Omental flap.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1
Fig. 1
Anterior abdominal wall mass.
Fig. 2
Fig. 2
The defect post wide local excison of the mass.
Fig. 3
Fig. 3
sandwich omental flap.
Fig. 4
Fig. 4
follow up images 2 years later with a hernia defect.
See this image and copyright information in PMC

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