Incarcerated Littre’s Hernia: A Case Report

Abstract

Introduction: Meckel’s diverticulum is a congenital anomaly of the gastrointestinal tract. It is usually asymptomatic and occurs in approximately 0.6% to 4% of individuals. A Littre’s hernia is defined as the presence of a Meckel’s diverticulum within a hernia sac. Littre’s hernias can occur at various anatomical sites, including inguinal, femoral, and umbilical locations.

Clinical Case: An 80-year-old female presented to the emergency department of a quaternary care center with a 14-hour history of symptoms compatible with a right inguinal hernia (indirect) incarcerated NYHUS IIIB, containing a narrow-necked Meckel’s diverticulum, constituting a mixed Littre’s hernia.

Results: Few cases of Littre’s hernias have been reported in the literature, with an approximate incidence of 1% among patients with a Meckel’s diverticulum. Diagnosis is typically intraoperative, with clinical manifestations including abdominal pain and distension. Complications such as obstruction and incarceration occur similarly to other abdominal wall hernias. Management is based on both hernia repair and resection of the diverticulum.

Conclusions: To date, no standardized consensus exists regarding the surgical approach for this condition, particularly when it is an incidental finding. Surgical technique may depend on multiple factors, making knowledge of anatomy, clinical presentation, and diagnostic imaging crucial for timely diagnosis and treatment of Littre’s hernia.