A Strangulated Meckel’s Diverticulum in an Inguinal Hernia: A Case Report and Literature Review
Garrett Johnson, J. Sinclair Holden, Ramzi M. Helewa, David Hochman, Eric Hyun
Abstract
BACKGROUND: 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.