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In this case report, the authors describe the successful treatment of a large ASM through drainage and watertight closure of the cyst with an omental flap.<\/jats:p><jats:p>A 43-year-old woman with a history of Marfan syndrome and a large ASM was referred for neurosurgical intervention. The ASM was filling the pelvic cavity and causing severe compression of the bladder. The patient underwent surgical decompression of the cyst through an anterior transabdominal approach and closure of the fistulous tract with a pedicled omental flap. This is the first reported case of successful closure of an ASM with an omental flap. At the 6-month follow-up, the ASM had not recurred on imaging and the patient\u2019s symptoms had resolved.<\/jats:p><jats:p>Anterior sacral meningoceles are rare lesions that often require neurosurgical intervention. Although most can be treated posteriorly, large ASMs compressing the abdominal or pelvic organs may require a transabdominal approach. Moreover, ASMs with wide dural stalks may benefit from closure with an omental flap.<\/jats:p>","DOI":"10.3171\/2018.1.spine171303","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T15:08:17Z","timestamp":1527260897000},"page":"182-186","source":"Crossref","is-referenced-by-count":10,"title":["Closure of a giant anterior sacral meningocele with an omental flap in a patient with Marfan syndrome: case report"],"prefix":"10.3171","volume":"29","author":[{"given":"Gabriella M.","family":"Paisan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth M.","family":"Crandall","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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