Closure of large meningomyelocele wound defects with subcutaneous based pedicle flap with bilateral V-Y advancement is an effective technique. The main advantages of this technique are its simplicity, short operative time, good tolerance, early healing, and good cosmetic outcome with an excellent flap texture and contour match with minimal complications.

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Solitary crossed renal ectopia (SCRE) is an exceedingly rare anomaly of the urinary tract. So far, only 34 cases have been reported in the literature. It usually presents after infancy. Most of these cases are diagnosed incidentally while patients are undergoing evaluation for associated genitourinary, cardiovascular, hematological or vertebral abnormalities. We report the first case of SCRE presenting in neonatal age with impaired renal function and vesico-ureteric reflux.

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Epigastric heteropagus is an extremely rare congenital anomaly, in which there is asymmetrical conjoined twinning, with the parasitic twin attached to the epigastrium. A 2-day-old male, with epigastric heteropagus and omphalocele, was operated in our institution. After excision of the parasitic twin, omphalocele was covered with a gluteal skin flap available from the parasitic twin. Post-operative course was uneventful, except for infection along the edges of the skin flaps, which was managed conservatively. Only 44 cases of epigastric heteropagus twins have been reported previously in world literature. We present a novel surgical approach for the repair of the omphalocele in a case of epigastric heteropagus twins, probably the 45th case to be reported in the world literature.