Description

A 67-year-old man with a history of bilateral inguinal hernioplasty presented to the emergency department with abdominal pain for 2 days with no obstructive symptoms. Physical examination revealed a right inguinal swelling. Ultrasography findings reported a small incarcerated hernia and he underwent a corrective surgery by anterior transverse para-inguinal approach. Instead of a recurrent inguinal hernia, we found a femoral incarcerated hernia—rare in male patients. After opening the hernial sac, there was a Littré femoral incarcerated hernia (figure 1). We performed a pre-peritoneal hernia reduction, showing a Meckel’s diverticulum (figure 2). Diverticulectomy and pre-peritoneal hernioplasty went with no perioperative complications until discharge.

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Figure 1

Littré femoral incarcerated hernia after opening the hernial sac.

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Figure 2

Meckel’s diverticulum, after pre-peritoneal hernia reduction.

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract,1 but the occurrence of a Littré’s hernia is an extremely rare condition. The herniation of a Meckel’s diverticulum was first described by the French Surgeon Aléxis Littré in 1700,2 and have less than 50 cases described in the literature over the past 300 years. The anatomical sites of a Littre hernia can vary, but according to the last biggest systematic review, most cases concerned incarcerated hernias: 39.6% were femoral and 34% inguinal.3