Case Report Rare Presentation of a Case of Littre's Hernia – a Case Report How to Cite This Article (original) (raw)
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Littré’s hernia: a rare complication of Meckel’s diverticulum
International Surgery Journal, 2017
Littré’s hernia is caused by the protrusion of Meckel’s diverticulum through an orifice in the abdominal wall. Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract that is generally asymptomatic and only manifests in a specific way when complications exist. An unusual complication of Meckel’s diverticulum is known as Littre’s hernia. It comprises less than 1% of all Meckel’s diverticulum. Usual sites of Littre hernia are right inguinal (50% of cases), umbilical hernia (20%), and femoral hernia (20%). We present a case of Littré’s hernia where we found a strangulated Meckel’s diverticulum in an inguinal hernia sac.
An unusual complication of Meckel�s diverticulum: Littre�s hernia
Pan African Medical Journal, 2018
Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract. Any hernia sacs containing Meckel's diverticulum is called Littre's hernia. It was described for the first time in 1700 by Alexis Littre. The diagnosis is unlikely to be made preoperatively and surgery is the treatment of choice. We report a rare case of Littre's hernia who presented with clinical signs of intestinal obstruction.
Hernia : the journal of hernias and abdominal wall surgery, 2009
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract and is the result of the incomplete obliteration of the omphalomesenteric duct. Herniation of Meckel's diverticulum is called Littre's hernia and is a rare occurrence. Herein is described an extremely rare case of incarcerated and strangulated Meckel's diverticulum through an incisional ventral defect in a 59-year-old female patient, who presented with manifestations of acute surgical abdomen. At emergency laparotomy, a strangulated small-bowel loop containing a Meckel's diverticulum was found, which had migrated through the subcutaneous tissues to the right iliac fossa, where a painful mass was palpated on admission. Segmental resection of the ischemic ileum was performed and the abdomen was closed without the use of a prosthetic mesh. Histopathological findings were suggestive of a true diverticulum containing heterotopic gastric mucosa.
RARE PRESENTATION OF A CASE OF LITTRE'S HERNIA – A CASE REPORT
Littre's Hernia is an abnormal protrusion of Meckel's Diverticulum through an abdominal opening. Alexis Littre first described the condition in relation to a femoral hernia in 1770 (1). It is a very rare condition and very few cases are reported till date. Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. It is a true diverticulum found in the anti-mesentric border. It is the remnant of the persistent intestinal part of the vitello-intestinal or omphalo-enteric duct and comprises of all intestinal layers (2, 3, 4). It is found in 2% of total population, 2 feet from ileo-caecal junction and 2 inches in length, 2 types of common ectopic tissue (gastric and pancreatic). Meckel's diverticulum may be accompanied in the sac by the ileal loop to which it is attached; rarely, it may undergo incarceration or strangulation, necrosis, and perforation. In children, it is mostly found in umbilical hernias in which case it is more prone to adhere to the sac. Intestinal obstruction may occur due to volvulus, intussusception or very rarely as a complication of Littre's hernia (2, 3, 5). Its diagnosis is usually difficult despite the availability of modern investigative tools. A high index of suspicion is mandatory. In most cases it is an incidental finding. Hernial obstruction and strangulation of Meckel's diverticulum (Littre's Hernia) is a rare phenomenon and representing 10% of all complications of Meckel's diverticulum (6, 7). Surgery is the mainstay of treatment. We herein present an extremely rare case of strangulated Meckel's diverticulum in a Ventral Hernia (Littre's Hernia) which only became evident during surgery. The ventral hernia developed following emergency appendicectomy operation done for acute appendicitis 5 months back. CASE REPORT: A 47 years old male patient was admitted through Emergency with complaints of diffuse abdominal pain with distension, intermittent vomiting, dyspepsia and anorexia for last 2 days. There was no history of loose motion, fever or bleeding per rectum. The patient had undergone emergency appendicectomy five months back. On clinical examination, tachycardia (110 / minute) was noted, blood pressure was 146/90 mm. of Hg and slightly dehydrated; a very tender irreducible lump was found at the region of scar (right lower paramedian incision) of previous appendicectomy operation; absent peristaltic sounds. The cough impulse was absent. Examination of other systems was unremarkable. Straight X-ray abdomen showed multiple distended bowel loops with fluid levels; Ultrasound scan suggested an obstructed loop of intestine at the hernia site. The diagnosis of strangulated ventral hernia was made and emergency surgery was planned after resuscitation with IV fluids and antibiotics. Abdomen was opened through the scar of the previous appendicectomy operation; careful and meticulous dissection revealed the hernia sac which was opened; foul smelling dirty fluid was mopped up and the constricting ring-like formation in the anterior sheath was cut. The sac contained the inflamed Meckel's diverticulum with a part (about 5 cm) of ileum. The whole of
LITTRE'S HERNIA: A SURGICAL DILEMMA
International Journal of Medical Reviews and Case Reports, 2023
Meckel's diverticulum in a hernia sac is designated as a Littre's hernia. It is an uncommon type of hernia. The diagnosis is invariably made at the time of surgery. Resection anastomosis of the adjacent segment of the small bowel with the diverticulum is a contentious issue. A case of Littre's hernia is reported. A case of Littre's hernia in a 17-year-old boy is reported to highlight the diagnostic and therapeutic issues confronting the attending surgeon. A short segment resection anastomosis of the small bowel along with the Meckel's diverticulum was done. A herniorrhaphy was done with no complications. The diagnostic challenges, the dilemma of selecting the best option for removing Meckel's diverticulum, and the choice of hernia repair are discussed. Littre's hernia is invariably diagnosed intraoperatively. A short segment resection anastomosis of the adjacent small bowel and Meckel's diverticulum prevents complications arising due to the diverticulum. A herniorrhaphy for a young patient and the use of an absorbable mesh for other age groups is advisable.
Strangulated Littré Hernia; A Diagnostic Challenge for the Surgeon: Case Report
World Journal of Surgery and Surgical Research, 2024
Meckel's Diverticulum (MD) is a saccular formation present in the lower part of the intestine, and is considered one of the most common congenital anomalies of the gastrointestinal tract. The bulge of muscular dystrophy in a hernia sac is called a Littre's hernia. The name originates from Alexis Littre, who first described this disease in the eighteenth century. This type of presentation is rare; only a few cases have been reported in the literature
Meckel's diverticulum in a strangulated femoral hernia. Case report and review of literature
2011
Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. In the vast majority of cases it remains asymptomatic throughout life but in about 5% of cases it gives rise to complications, namely, haemorrhage, intestinal obstruction and inflammation. A rare complication is being presented--a femoral hernia containing a strangulated Meckel's diverticulum. This is known as Littre's hernia, which often exhibits subtle variations from the norm in its presentation. Preoperative diagnosis of Littre's hernia containing Meckel's diverticulum is rather difficult; almost always, the strangulated diverticulum is first discovered during operation. The diverticulum was resected and the femoral canal closed by a polypropylene mesh plug. The patient underwent an uneventful recovery and was discharged home on the fourth postoperative day. Complications arising from Meckel's diverticulum usually occur at a young age, with the ectopic tissue pr...
Gastrointestinal perforation due to incarcerated Meckel's diverticulum in right femoral canal
World journal of clinical cases, 2014
Meckel's diverticulum is a very common congenital anomaly of the gastrointestinal tract but many cases remain asymptomatic and are diagnosed incidentally during laparoscopic or other surgical procedures. Cases of femoral hernia involving Meckel's diverticulum are rare, with less than 50 cases reported in the literature since Littre published the first description of this coincident condition over 300 years ago. While all true "Littre' s hernias" contain a Meckel's diverticulum, the involved anatomical sites are various, the most common being the inner groin (inguinal), the outer groin (femoral), and the belly button (umbilical). Complications of Littre' s hernias include incarceration, strangulation, necrosis, and perforation. Herein, we describe a case of Littre's hernia that involved an incarcerated Meckel's diverticulum in a femoral hernia that was diagnosed upon investigation of symptomology manifesting from perforation and was successfully managed by surgical resection with stapler devices.
Littre hernia in childhood: A case report with a brief review of the literature
African Journal of Paediatric Surgery, 2011
A 3-year-old boy with a right-sided and painful inguinal swelling for the last 2 h was admitted to the emergency department. As there were no apparent peritoneal irritation fi ndings, right-sided incarcerated inguinal hernia was reduced and the patient was scheduled for an elective herniorrhaphy. Perioperatively even though the sac seemed empty, it was opened in order to inspect its content. The adherence of Meckel's diverticulum (MD) to the base of hernial sac was realized and Littre hernia (LH) was diagnosed. The hernia was highly ligated after the wedge resection of the diverticulum and anastomosis. The patient was fed on the second postoperative day and discharged on the third postoperative day. Despite numerous presentations of LH in the adult age group in the literature, there are limited data about the disease in the childhood period. Even though the scarcity of the data, there are some so-called rules for LH in childhood like protruding more common through umbilical hernias, containing heterotopic tissues more frequent than adult age and incarcerating/strangulating more often. The aim of this study is to review the reported LH cases, present a new case and discuss the features of LH in childhood period.