A Strangulated Meckel’s Diverticulum in an Inguinal Hernia: A Case Report and Literature Review

Abstract

Garrett GRJ Johnson,1,2 James Holden,1 Ramzi M Helewa,1 David Hochman,1 Eric Hyun1 1Department of Surgery, Section of General Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; 2Clinician Investigator Program, University of Manitoba, Winnipeg, Manitoba, CanadaCorrespondence: Eric HyunSt. Boniface Hospital, Z3037 - 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, CanadaEmail [email protected]: Meckel’s diverticulum is an embryologic remnant of the vitelline duct, occurring in approximately 2% of the adult population. A hernia containing a Meckel’s diverticulum is called a Littré’s hernia and is rarely reported in the medical literature. Clinically, a Littré’s hernia is indistinguishable from a hernia containing small bowel and is often discovered incidentally during a repair.Case Presentation: Herein, we report a rare case of strangulated Littré’s hernia in a patient’s right groin. The sac contained a long segment of small bowel in addition to a large Meckel’s diverticulum. The bowel was irreducible through the groin incision, and a lower midline laparotomy was made. Necrotic bowel including the Meckel’s diverticulum was resected. Given the presence of necrotic bowel and potential for infection, the hernia was repaired with a Bassini herniorrhaphy, reinforced with absorbable mesh. The patient recovered uneventfully.Conclusion: Littré’s hernia is a rare clinical entity. Treatment is similar to any bowel-containing hernia. Repair of the hernia defect with permanent mesh should be weighed against the risk of implant infection.Keywords: Meckel’s diverticulum, Littré’s hernia, inguinal hernia

Keywords

• meckel's diverticulum
• littré's hernia
• inguinal hernia.